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General NPI Number Information
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NPI Number | 1669848461
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Entity Type | Individual
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Provider Name | GRACIELA ACEVEDO F.N.P.
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Gender | Female
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Dates
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Enumeration Date | 08/15/2015
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Last Update Date | 12/01/2015
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Provider Practice Location Address
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Address Line | 383 W 34TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-4309
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Country | US
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Telephone | 305-823-3312
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Fax | 305-884-3989
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Provider Business Mailing Address
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Address Line | 167 W 23RD ST
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City | HIALEAH
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State | FL
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Zip | 33010-2211
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Country | US
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Telephone | 305-823-3312
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Fax | 305-884-3989
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9295788
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License Number State | FL
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