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DR. MARTHA IVON ACOSTA MD
>> Pediatrics >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1275697542
Individual Registrant:DR. MARTHA IVON ACOSTA MD
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
201 HILDA ST STE 15 KISSIMMEE, FL 34741-2359 US
Tel: 407-574-4848 Fax: 407-518-1919
Tel: 407-574-4848 Fax: 407-518-1919
Contact information for business:
201 HILDA ST STE 15 KISSIMMEE, FL 34741-2359 US
Tel: 407-574-4848 Fax: 407-518-1919
Tel: 407-574-4848 Fax: 407-518-1919
Registration Information:
NPI: 1275697542
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 208000000X | Allopathic & Osteopathic Physicians Pediatrics | PR | 13965 |
| Y | 208000000X | Allopathic & Osteopathic Physicians Pediatrics | FL | ACN 253 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 77003 | FL | 05 | |
| 51062 | FL | 05 | |
| 59608 | FL | 05 | |
| HUMANA | 61101P | FL | 01 |
| CIGNA | 5324601 | FL | 01 |
| 000491400 | FL | 05 | |
| AMBETTER | 68069 | FL | 01 |
| 87726A | FL | 05 |
