Provider Demographics
NPI:1104845767
Name:ACEVEDO ACOSTA, GILBERT (MD)
Entity type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:
Last Name:ACEVEDO ACOSTA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 S DOUGLAS RD STE 308
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6134
Mailing Address - Country:US
Mailing Address - Phone:305-913-9454
Mailing Address - Fax:305-442-1198
Practice Address - Street 1:2250 OSPREY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-4340
Practice Address - Country:US
Practice Address - Phone:863-644-8459
Practice Address - Fax:863-533-8215
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1010208D00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLACN1010OtherSTATE LICENSE
FL125919800Medicaid
FLPZ074OtherMEDICARE
FLACN1010OtherSTATE LICENSE
FLACN1010OtherSTATE LICENSE