Provider Demographics
NPI:1386036150
Name:ACOSTA, IRMA (PA-C)
Entity type:Individual
Prefix:
First Name:IRMA
Middle Name:
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N PARK AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-4121
Mailing Address - Country:US
Mailing Address - Phone:407-814-2680
Mailing Address - Fax:407-814-2069
Practice Address - Street 1:201 N PARK AVE STE 201
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4121
Practice Address - Country:US
Practice Address - Phone:407-814-2680
Practice Address - Fax:407-814-2068
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108058363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical