Provider Information for 1316960800
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JAIME ACOSTA L.C.S.W.
Sex: Male
NPI: 1316960800
Last Updated: 2024-09-23
Certification Date: 2024-09-23
Certification Date: 2024-09-23
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1316960800 | ||||||||
| Enumeration Date | 2006-07-25 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 253 NE 2ND ST APT 1704 MIAMI, FL 33132-2292 United States Phone: 786-525-7470 | Fax:786-796-5253 | ||||||||
| Primary Practice Address | 253 NE 2ND ST APT 1704 MIAMI, FL 33132-2292 United States Phone: 786-525-7470 | Fax:786-796-5253 | ||||||||
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