Healthcare Provider Details

I. General information

NPI: 1497837397
Provider Name (Legal Business Name): FERNANDO ROBLES-ACEVEDO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BDAACH/549TH HC USAG CAMP HUMPHREYS, BLDG. # 3030
APO AP
96271
US

IV. Provider business mailing address

BDAACH/549TH HC USAG CAMP HUMPHREYS, BLDG. # 3030
APO AP
96271
US

V. Phone/Fax

Practice location:
  • Phone: 315-737-1219
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number12953
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: