Healthcare Provider Details

I. General information

NPI: 1851390017
Provider Name (Legal Business Name): CELSO ACEVEDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 SW 20TH PL
OCALA FL
34471-7734
US

IV. Provider business mailing address

2111 SW 20TH PL
OCALA FL
34471-7734
US

V. Phone/Fax

Practice location:
  • Phone: 352-622-4251
  • Fax: 352-622-0102
Mailing address:
  • Phone: 352-622-4251
  • Fax: 352-622-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME95993
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME95993
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: