Healthcare Provider Details

I. General information

NPI: 1508498585
Provider Name (Legal Business Name): ARACELY ACOSTA R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARACELY ACOSTA RPH

II. Dates (important events)

Enumeration Date: 02/07/2020
Last Update Date: 02/07/2020
Certification Date: 02/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1484 AVE. F.D. ROOSEVELT SUITE 19
SAN JUAN PR
00920
US

IV. Provider business mailing address

COND EL LAUREL J-8 AVE. SAN PATRICIO # 36
GUAYNABO PR
00968
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-4510
  • Fax: 787-792-0831
Mailing address:
  • Phone: 787-783-4510
  • Fax: 787-792-0831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number3039
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: