Provider Demographics
NPI:1659724615
Name:ACOSTA, DIONISIO JOEL (MD)
Entity Type:Individual
Prefix:
First Name:DIONISIO
Middle Name:JOEL
Last Name:ACOSTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DIONISIO
Other - Middle Name:JOEL
Other - Last Name:ACOSTA MARTINEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1050 AVE LOS CORAZONES STE 102
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-7058
Mailing Address - Country:US
Mailing Address - Phone:787-834-5334
Mailing Address - Fax:
Practice Address - Street 1:1050 AVE LOS CORAZONES STE 102
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-7058
Practice Address - Country:US
Practice Address - Phone:787-834-2185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21936207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine