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NPI 1942315346

NPI 1942315346 : ELBA I ACEVEDO : MOCA, PR

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General NPI Number Information
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    NPI Number           |    1942315346
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    Entity Type          |    Individual 
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    Provider Name        |    ELBA I ACEVEDO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/19/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    245 CONCEPCION VERA STREET 
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    City                 |    MOCA
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    State                |    PR
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    Zip                  |    00676
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    Country              |    US
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    Telephone            |    787-877-0110
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    Fax                  |    787-877-0110
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1615 
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    City                 |    MOCA
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    State                |    PR
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    Zip                  |    00676-1615
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    Country              |    US
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    Telephone            |    787-207-6523
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    Fax                  |    787-877-5803
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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        |    183700000X
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    Taxonomy Name        |    Pharmacy Technician
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    License Number       |    2679
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    License Number State |    PR
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