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Individual
IDALIA A ACOSTA
Active
Individual
IDALIA A ACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME0066961
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25992
BCBS PROV NUMBER
FL
05
—
375698000
—
FL
01
—
ME0066961
MEDICAL LICENSE NUMBER
FL
Enumeration date
09/13/2006
Last updated
06/01/2009
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