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General NPI Number Information
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NPI Number | 1730176595
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Entity Type | Individual
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Provider Name | LUZ M ACEVEDO-VARGAS MD
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Gender | Female
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | D22 CALLE YUNQUESITO URB LOMAS DE CAROLINA
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City | CAROLINA
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State | PR
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Zip | 00987-8008
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Country | US
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Telephone | 787-757-6545
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Fax | 787-757-7820
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Provider Business Mailing Address
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Address Line | 265A CALLE 20 URB PONCE DE LEON
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City | GUAYNABO
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State | PR
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Zip | 00969-4447
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Country | US
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Telephone | 787-757-6545
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Fax | 787-757-7820
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 8710
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License Number State | PR
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