# AGOSTO DIABETES-THYROID AND ENDOCRINOLOGY CSP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780970178
- **Authorized official:** DR. MARIELBA AGOSTO MUJICA M.D. (PRESIDENT)
- **Authorized official phone:** (787) 402-7693

## Contact information

- **Practice address:** 109 AVE JOSE DE DIEGO E, CAYEY, PR 00736-3822
- **Practice address phone:** (787) 402-7693
- **Practice address fax:** (787) 905-7908
- **Mailing address:** PO BOX 6400, CAYEY, PR 00737-6400
- **Mailing address phone:** (787) 402-7693
- **Mailing address fax:** (787) 905-7908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 15558 | PR | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 15558 | PR | Yes |
| 208D00000X | General Practice Physician | 15151 | PR | — |

## Other

- **Enumeration date:** 06/23/2011
- **Last updated:** 08/20/2020