Healthcare Provider Details

I. General information

NPI: 1497763668
Provider Name (Legal Business Name): MIDNELA ACEVEDO-FLORES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PMB 215 70344
SAN JUAN PR
00936-8344
US

IV. Provider business mailing address

215 PO BOX 70344
SAN JUAN PR
00936-8344
US

V. Phone/Fax

Practice location:
  • Phone: 178-776-5418
  • Fax: 178-775-1514
Mailing address:
  • Phone: 178-776-5418
  • Fax: 178-775-1514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number8441
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: