MEDICARE: DR. WILLIAM ACEVEDO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	10204	PR

General Provider Information

NPI Number	:	1346289659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM ACEVEDO M.D.

Provider Business Mailing Address
First Line	:	6 CALLE TAPIA
Second Line	:	OCEAN PARK
City	:	SAN JUAN
State	:	PR
Zip	:	00911-1442
Country	:	US
Telephone Number	:	787-641-2977
Fax Number	:	787-641-5716

Provider Business Practice Location Address
First Line	:	6 CALLE TAPIA
Second Line	:	OCEAN PARK
City	:	SAN JUAN
State	:	PR
Zip	:	00911-1442
Country	:	US
Telephone Number	:	787-641-2977
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	12/13/2010

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