MEDICARE: DR. LUIS ANTONIO ACEVEDO AQUINO MD

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	207R00000X	Internal Medicine Physician	24342	PR

General Provider Information

NPI Number	:	1477128999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIS ANTONIO ACEVEDO AQUINO MD

Provider Business Mailing Address
First Line	:	PO BOX 511
Second Line	:
City	:	SAN ANTONIO
State	:	PR
Zip	:	00690-0511
Country	:	US
Telephone Number	:	787-673-4392
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARR 459 KM 8.3 BO. MONTANA
Second Line	:
City	:	AGUADILLA
State	:	PR
Zip	:	00603
Country	:	US
Telephone Number	:	787-673-4392
Fax Number	:

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

Provider Enumeration Date	:	05/26/2021
Last Update Date	:	06/02/2026

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