Provider Demographics
NPI:1851799241
Name:ADORNO AGOSTO, JULIO
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:
Last Name:ADORNO AGOSTO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 91 BUZON 9323
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00692
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HC 91 BUZON 9323
Practice Address - Street 2:
Practice Address - City:VEGA ALTA
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00692
Practice Address - Country:UM
Practice Address - Phone:787-382-3979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR59246XC2903X
PR47246XS1301X
PR792471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular Specialist
No246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography