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General NPI Number Information
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NPI Number | 1982676755
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Entity Type | Organization
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Legal Business Name | LUIS A ACEVEDO
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 04/23/2018
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Provider Practice Location Address
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Address Line | 50 CALLE BRAZIL STE 2 GARDENVILLE
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City | GUAYNABO
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State | PR
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Zip | 00966-2037
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Country | US
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Telephone | 787-782-1180
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Fax | 787-782-2765
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Provider Business Mailing Address
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Address Line | BRASIL 50 SUITE 2 GARDENVILLE
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City | GUAYNABO
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State | PR
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Zip | 00966
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Country | US
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Telephone | 787-782-1180
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Fax | 787-782-2765
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Authorized Official
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Title or Position | PHARMACIST AND OWNER
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Name | LUIS ACEVEDO
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Credential |
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Telephone | 787-782-1180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 19F1412
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License Number State | PR
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