Provider Demographics
NPI:1912045378
Name:ACOSTA, RAUL ARTURO (MD)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:ARTURO
Last Name:ACOSTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2110
Mailing Address - Street 2:
Mailing Address - City:YABUCOA
Mailing Address - State:PR
Mailing Address - Zip Code:00767-2110
Mailing Address - Country:US
Mailing Address - Phone:787-449-0413
Mailing Address - Fax:787-893-5548
Practice Address - Street 1:URB. MENDEZ MARGINAL #6 SUITE 1
Practice Address - Street 2:
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767
Practice Address - Country:US
Practice Address - Phone:787-266-0242
Practice Address - Fax:787-893-5548
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8806208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice