MEDICARE: DR. JEREMY LI AGOSTINHO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	95983	SC

General Provider Information

NPI Number	:	1346602018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEREMY LI AGOSTINHO M.D.

Provider Business Mailing Address
First Line	:	506 E CHEVES ST STE 202
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29506-2616
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3781 MCDOWELL LN STE 200
Second Line	:
City	:	LITTLE RIVER
State	:	SC
Zip	:	29566-8930
Country	:	US
Telephone Number	:	843-366-6010
Fax Number	:	843-366-2485

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	01/29/2026

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