Provider Demographics
NPI:1881374924
Name:LOPEZ ACOSTA, ALBERTO CARLOS (APRN)
Entity type:Individual
Prefix:
First Name:ALBERTO CARLOS
Middle Name:
Last Name:LOPEZ ACOSTA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9193 SUNSET DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3487
Mailing Address - Country:US
Mailing Address - Phone:305-273-9377
Mailing Address - Fax:305-273-9388
Practice Address - Street 1:9193 SUNSET DR STE 200
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3487
Practice Address - Country:US
Practice Address - Phone:305-273-9377
Practice Address - Fax:305-273-9388
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11027299363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty