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Individual

DR. RUDOLPH ACOSTA JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12408 N 56TH ST, SUITE 1, TAMPA, FL 33617
(813) 980-3104
(813) 980-3106
Mailing address
12408 N 56TH ST, SUITE 1, TAMPA, FL 33617
(813) 980-3104
(813) 980-3106

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME47932
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0451879
AETNA
FL
01
1642018006
CIGNA
FL
05
260315200
FL
01
340001936
RAILROAD MEDICARE
FL
Enumeration date
08/11/2006
Last updated
09/17/2012
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