Provider Demographics
NPI:1376422535
Name:AGOSTO BAEZ, EVA LEONOR
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:LEONOR
Last Name:AGOSTO BAEZ
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 INDEPENDENCE WAY STE D3
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3875
Mailing Address - Country:US
Mailing Address - Phone:978-924-5659
Mailing Address - Fax:
Practice Address - Street 1:100 INDEPENDENCE WAY STE D3
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3875
Practice Address - Country:US
Practice Address - Phone:978-924-5659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-30
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator