MEDICARE: DR. DAVID ACEVEDO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	14454	PR

General Provider Information

NPI Number	:	1467443937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ACEVEDO M.D.

Provider Business Mailing Address
First Line	:	PMB 120 PO BOX 4960
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00726-4960
Country	:	US
Telephone Number	:	787-315-6951
Fax Number	:	787-286-6161

Provider Business Practice Location Address
First Line	:	PLAZA DEL CARMEN MALL # 24
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00725-0000
Country	:	US
Telephone Number	:	787-315-6951
Fax Number	:	787-286-6161

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	07/08/2007

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