Healthcare Provider Details

I. General information

NPI: 1518908102
Provider Name (Legal Business Name): CARMEN M ACEVEDO RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 CALLE DR CUETO
UTUADO PR
00641-2850
US

IV. Provider business mailing address

PO BOX 27
UTUADO PR
00641-0027
US

V. Phone/Fax

Practice location:
  • Phone: 787-894-2190
  • Fax: 787-894-2829
Mailing address:
  • Phone: 787-894-2190
  • Fax: 787-984-2829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1983
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: