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General NPI Number Information
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NPI Number | 1609019918
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Entity Type | Individual
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Provider Name | ERICH GLENN C ACEBEDO MD
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Gender | Male
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Dates
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Enumeration Date | 04/16/2009
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 11380 PROSPERITY FARMS RD STE 104
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-3450
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Country | US
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Telephone | 561-283-1166
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Fax | 561-910-4645
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Provider Business Mailing Address
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Address Line | 11380 PROSPERITY FARMS RD STE 104
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-3450
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Country | US
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Telephone | 561-283-1166
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Fax | 561-910-4645
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C161085
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036122547
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 14302
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License Number State | NV
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