Healthcare Provider Details

I. General information

NPI: 1154828937
Provider Name (Legal Business Name): DIONISIO LUIS ACOSTA MARTINEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROCHELAISE CENTE OFICINA 3D WESTERN INDUSTRIAL PARK
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

8 VILLA GRACIA
MAYAGUEZ PR
00680-7171
US

V. Phone/Fax

Practice location:
  • Phone: 939-373-6791
  • Fax: 708-797-7218
Mailing address:
  • Phone: 939-373-6791
  • Fax: 708-718-7977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number21478
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: