Healthcare Provider Details

I. General information

NPI: 1477462638
Provider Name (Legal Business Name): DR. EMMANUEL ACEVEDO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE JOAQUIN M ANDINO 14C
ADJUNTAS PR
00602
US

IV. Provider business mailing address

HC 61 BOX 34176
AGUADA PR
00602-9438
US

V. Phone/Fax

Practice location:
  • Phone: 939-289-5301
  • Fax:
Mailing address:
  • Phone: 787-546-6309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1139
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: