MEDICARE: DIONISIO JOEL ACOSTA MD

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	207R00000X	Internal Medicine Physician	21936	PR
2	207RN0300X	Nephrology Physician	21936	PR

General Provider Information

NPI Number	:	1659724615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIONISIO JOEL ACOSTA MD

Provider Business Mailing Address
First Line	:	1050 AVE LOS CORAZONES STE 102
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00680-7058
Country	:	US
Telephone Number	:	787-834-5334
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 AVE LOS CORAZONES STE 102
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00680-7058
Country	:	US
Telephone Number	:	787-834-2185
Fax Number	:

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

Provider Enumeration Date	:	07/14/2016
Last Update Date	:	01/02/2024

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