Organization
NILDA ACOSTA MD PA
Active
Other names
Excellence Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
NILDA ACOSTA (MANAGED CARE SPECIALIST)
(800) 654-0889
Entity
Organization
Contact information
Practice address
1235 N KROME AVE, HOMESTEAD, FL 33030-4204
(305) 242-5336
(305) 242-5337
Mailing address
1235 N KROME AVE, HOMESTEAD, FL 33030-4204
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
ME61179
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019149
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
373407201
—
FL
Enumeration date
08/18/2006
Last updated
02/26/2013
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