Organization
AGOSTO DIABETES-THYROID AND ENDOCRINOLOGY CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIELBA AGOSTO MUJICA M.D. (PRESIDENT)
(787) 402-7693
Entity
Organization
Contact information
Practice address
109 AVE JOSE DE DIEGO E, CAYEY, PR 00736-3822
(787) 402-7693
(787) 905-7908
Mailing address
PO BOX 6400, CAYEY, PR 00737-6400
(787) 402-7693
(787) 905-7908
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
15558
PR
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
15558
PR
208D00000X
General Practice Physician
15151
PR
Other
Enumeration date
06/23/2011
Last updated
08/20/2020
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