Individual
ALESSANDRO L ACOSTA-FAJARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1317 W POINT DR, COCOA, FL 32922-6464
(321) 636-2621
(321) 631-9436
Mailing address
PO BOX 11406, BELFAST, ME 04915-4005
(321) 636-2621
(321) 631-9436
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0045737
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003142500
—
FL
Enumeration date
02/13/2006
Last updated
04/15/2015
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