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Individual

CRISTINA MARIA ACOSTA DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1700 S TAMIAMI TRL, SARASOTA, FL 34239-3509
(941) 917-4896
(941) 917-6884
Mailing address
PO BOX 947407, ATLANTA, GA 30394-7407
(941) 917-2600
(941) 917-2600

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME156969
FL
390200000X
Student in an Organized Health Care Education/Training Program
14655-I
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14655-I
PROVISIONAL LICENSE
PR
01
ME156969
FL MED LIC
FL
Enumeration date
01/22/2018
Last updated
03/07/2023
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