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DR. JASON ACOSTA MD

>> General Practice >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1689033201

Individual Registrant:
DR. JASON  ACOSTA MD
Gender: M
Sole Proprietor

Location and contact information for practice:
111 AVENUE A SE  WINTER HAVEN, FL 33880 US
Tel: 863-619-5999  Fax: 863-619-5995

Contact information for business:
4700 EXPLORATION AVE  LAKELAND, FL 33812-3319 US
Tel: 888-414-1413  Fax: 863-619-5995

Registration Information:
NPI: 1689033201
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N208D00000XAllopathic & Osteopathic Physicians
General Practice
PR13732I
Y208D00000XAllopathic & Osteopathic Physicians
General Practice
FLACN937

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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