Provider Demographics
NPI:1447290432
Name:ACOSTA-PEREZ, SIGFREDO (MD)
Entity type:Individual
Prefix:DR
First Name:SIGFREDO
Middle Name:
Last Name:ACOSTA-PEREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SIGFREDO
Other - Middle Name:P
Other - Last Name:ACOSTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:593 PEPPER DR APT D
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-7024
Mailing Address - Country:US
Mailing Address - Phone:321-795-2067
Mailing Address - Fax:
Practice Address - Street 1:593 PEPPER DR APT D
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-7024
Practice Address - Country:US
Practice Address - Phone:321-795-2067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 64632208000000X
CAG89403208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373676800Medicaid
FL186178OtherSTAYWELL ID #
CA37367680Medicaid
FL23749OtherBC-BS ID NUMBER
FL4348228OtherAETNA ID #
FL81083OtherCIGNA ID #
FL81083OtherCIGNA ID #
CA37367680Medicaid