Provider Demographics
NPI:1093263303
Name:ACEVEDO, JEAN CARLOS (DC)
Entity Type:Individual
Prefix:DR
First Name:JEAN CARLOS
Middle Name:
Last Name:ACEVEDO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 140382
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-0382
Mailing Address - Country:US
Mailing Address - Phone:787-607-2037
Mailing Address - Fax:
Practice Address - Street 1:CALLE 493 KM 0.9 BO CARRIZALES
Practice Address - Street 2:DEL NORTE PROFESSIONAL PLAZA OFFICE 101
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-607-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0612111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology