Healthcare Provider Details

I. General information

NPI: 1124017355
Provider Name (Legal Business Name): NILMA ACEVEDO AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 08/29/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 CALLE MENDEZ VIGO E
MAYAGUEZ PR
00680-5529
US

IV. Provider business mailing address

PO BOX 7388
MAYAGUEZ PR
00681-7388
US

V. Phone/Fax

Practice location:
  • Phone: 787-265-3190
  • Fax: 787-265-3190
Mailing address:
  • Phone: 787-265-3190
  • Fax: 787-265-3190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number545
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number545
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: