MEDICARE: MARIBEL ACEVEDO MD

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	208D00000X	General Practice Physician	14317	PR

General Provider Information

NPI Number	:	1699743864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIBEL ACEVEDO MD

Provider Business Mailing Address
First Line	:	18 ARBOLOTE AVE.
Second Line	:	PALMAR DEL RIO COND. #336
City	:	GUAYNABO
State	:	PUERTO RICO
Zip	:	00969
Country	:	UM
Telephone Number	:	787-528-1828
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 AVE ARBOLOTE
Second Line	:	PALMAR DEL RIO CONDOMINIUM APARTMENT A407
City	:	GUAYNABO
State	:	PR
Zip	:	00969-5511
Country	:	US
Telephone Number	:	787-528-1828
Fax Number	:

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	07/08/2007

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