MEDICARE: MANUEL ALEJANDRO ACEVEDO PENA 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	208D00000X	General Practice Physician	14980I	PR

General Provider Information

NPI Number	:	1740754340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANUEL ALEJANDRO ACEVEDO PENA MD

Provider Business Mailing Address
First Line	:	EL VALLE 101 CALLE PASEO DE LA PALMA REAL
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00727
Country	:	US
Telephone Number	:	939-276-6967
Fax Number	:	939-276-6967

Provider Business Practice Location Address
First Line	:	18 KM 141.1 BO. CAIMITAL BAJO
Second Line	:	HOSP. BUEN SAMARITANO AVE. SEVERIANO CUEVAS
City	:	AGUADILLA
State	:	PR
Zip	:	00603
Country	:	US
Telephone Number	:	787-658-0200
Fax Number	:

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

Provider Enumeration Date	:	01/16/2019
Last Update Date	:	06/04/2026

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