Jose David Acosta Sr., MD

Individual provider Active NPI Medical Physician Assistant · Vega Alta, PR

NPI 1265070957 · NPPES record last updated Dec 13, 2019

Key facts

NPI
1265070957
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
248 (PR)
Practice address
73 Calle 2
Vega Alta, PR 00692-5761
Phone
(939) 257-7874
NPI assigned
Dec 13, 2019
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 248 PR Yes

Addresses

Primary practice location

73 Calle 2
Vega Alta, PR 00692-5761

Mailing address

73 Calle 2
Vega Alta, PR 00692-5761
Phone (939) 257-7874

Other identifiers

IdentifierTypeStateIssuer
PA-248MedicaidPR

Other providers in Vega Alta, PR

All providers in Vega Alta, PR · Medical Physician Assistant in Puerto Rico

Sources for this page

Verify at the official NPI Registry.