Healthcare Provider Details

I. General information

NPI: 1861073819
Provider Name (Legal Business Name): JOSE I ACOSTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PASEO DR. JOSE CELSO BARBOSA, SAN JUAN, PUERTO RICO, 00
SAN JUAN PR
00921
US

IV. Provider business mailing address

PASEO DR. JOSE CELSO BARBOSA, SAN JUAN, PUERTO RICO, 00
SAN JUAN PR
00921
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number37998
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: