Provider Demographics
NPI:1164569067
Name:AGRONT, JOE D
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:D
Last Name:AGRONT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOE
Other - Middle Name:D
Other - Last Name:AGRONT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:HC 56 BOX 34454
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-9775
Mailing Address - Country:US
Mailing Address - Phone:787-252-0982
Mailing Address - Fax:
Practice Address - Street 1:260 CALLE COLON
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-2925
Practice Address - Country:US
Practice Address - Phone:787-868-3710
Practice Address - Fax:787-868-2940
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2681183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician