Organization
AGOSTO ALLERGY AND IMMUNOLOGY CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANARDI AGOSTO-MUJICA M.D. (PRESIDENT)
(787) 403-3611
Entity
Organization
Contact information
Practice address
109 AVE JOSE DE DIEGO E, ESQUINA CARRION MADURO, CAYEY, PR 00736-3822
(787) 635-4374
(787) 635-4374
Mailing address
75 CALLE EUSEBIO ITURRINO, CANOVANAS, PR 00729-3221
(787) 635-4374
(787) 905-7908
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
15888
PR
207R00000X
Internal Medicine Physician
15888
PR
207R00000X
Internal Medicine Physician
ME93943
FL
208000000X
Pediatrics Physician
15888
PR
208000000X
Pediatrics Physician
ME93943
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273367600
—
FL
01
—
28690
BLUE CROSS BLUE SHIELD
—
Enumeration date
06/22/2011
Last updated
08/20/2020
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