Healthcare Provider Details

I. General information

NPI: 1932514585
Provider Name (Legal Business Name): ITZA MARIE ACEVEDO OJEDA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 METRO MEDICAL CENTER SUITE 401-410
BAYAMON PR
00959-5065
US

IV. Provider business mailing address

1 AVE FOMENTO STE 1
CAGUAS PR
00725-5700
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-3030
  • Fax: 787-641-3031
Mailing address:
  • Phone: 787-641-3030
  • Fax: 787-641-3031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number24611
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number33130
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number135906
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: