Provider Demographics
NPI:1932782612
Name:ACOSTA PEREZ, ANNIA (APRN)
Entity Type:Individual
Prefix:
First Name:ANNIA
Middle Name:
Last Name:ACOSTA PEREZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7653 W 29TH LN APT 202
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-5179
Mailing Address - Country:US
Mailing Address - Phone:786-715-9505
Mailing Address - Fax:
Practice Address - Street 1:7653 W 29TH LN APT 202
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-5179
Practice Address - Country:US
Practice Address - Phone:786-715-9505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11012863363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily