Provider Demographics
NPI:1386799989
Name:ROBERTO J ACOSTA M D P A
Entity type:Organization
Organization Name:ROBERTO J ACOSTA M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:J
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-845-7770
Mailing Address - Street 1:1000 45TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2434
Mailing Address - Country:US
Mailing Address - Phone:561-845-7770
Mailing Address - Fax:561-842-2988
Practice Address - Street 1:1000 45TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2434
Practice Address - Country:US
Practice Address - Phone:561-845-7770
Practice Address - Fax:561-842-2988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252401500Medicaid
FL252401500Medicaid
FLG51375Medicare UPIN