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General NPI Number Information
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NPI Number | 1891607412
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Entity Type | Individual
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Provider Name | MIGUEL ANGEL CORREA ACEVEDO MD,PA
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Gender | Male
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | CARRETERA 111 KM 1.9
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City | LARES
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State | PR
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Zip | 00669
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Country | US
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Telephone | 787-897-2727
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE 10 CASA 219 ISLOTE 2
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City | ARECIBO
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State | PR
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Zip | 00612
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Country | US
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Telephone | 787-317-9308
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 3094
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License Number State | PR
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