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Individual

ILEANA ACOSTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
401 SW 42ND AVE STE 300, CORAL GABLES, FL 33134-1938
(305) 872-0008
(305) 928-1112
Mailing address
401 SW 42ND AVE STE 300, CORAL GABLES, FL 33134-1938
(305) 872-0008
(305) 928-1112

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ACN656
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
112-154-400
FL
Enumeration date
10/08/2014
Last updated
10/24/2022
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