Provider Demographics
NPI:1790343994
Name:OFICINA MEDICA DR. EDGARDO PRIETO AGOSTINI, CSP
Entity Type:Organization
Organization Name:OFICINA MEDICA DR. EDGARDO PRIETO AGOSTINI, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC
Authorized Official - Prefix:DR
Authorized Official - First Name:EDGARDO
Authorized Official - Middle Name:PRIETO
Authorized Official - Last Name:AGOSTINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-747-9000
Mailing Address - Street 1:PO BOX 1600
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-1600
Mailing Address - Country:US
Mailing Address - Phone:787-747-9000
Mailing Address - Fax:
Practice Address - Street 1:AVE JOSE MERCADO ESQ CRISTOBAL COLON EDIF SAN JUAN C
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727
Practice Address - Country:US
Practice Address - Phone:787-747-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty