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NPI Code Detail

MEDICARE: MR. JOHN TIMOTHY ACEVEDO SR.

MEDICARE: MR. JOHN TIMOTHY ACEVEDO SR.
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1497958953
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN TIMOTHY ACEVEDO SR.
Provider Business Mailing Address
First Line : 1231 N TUTTLE AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34237-3116
Country : US
Telephone Number : 941-366-0461
Fax Number : 941-951-1795
Provider Business Practice Location Address
First Line : 1231 N TUTTLE AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34237-3116
Country : US
Telephone Number : 941-366-0461
Fax Number : 941-951-1795
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2007
Last Update Date : 07/08/2007

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