Healthcare Provider Details

I. General information

NPI: 1689134470
Provider Name (Legal Business Name): SHEILA ACOSTA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE HERNANDEZ CARRION URB. ATENAS
MANATI PR
00674
US

IV. Provider business mailing address

CALLE HERNANDEZ CARRION URB. ATENAS
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 787-621-3700
  • Fax:
Mailing address:
  • Phone: 787-621-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number23527
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: