MEDICARE: DR. CARLOS A 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	6546	PR

General Provider Information

NPI Number	:	1821092586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLOS A ACOSTA MD

Provider Business Mailing Address
First Line	:	PO BOX 9427
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00960-9427
Country	:	US
Telephone Number	:	787-798-5125
Fax Number	:	787-798-5125

Provider Business Practice Location Address
First Line	:	EDIF MEDICO HNAS DAVILA SUITE 207
Second Line	:	VILLA RICA
City	:	BAYAMON
State	:	PR
Zip	:	00959
Country	:	US
Telephone Number	:	787-798-5125
Fax Number	:	787-798-5125

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	11/10/2011

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