Provider Demographics
NPI:1114993912
Name:ORDUNA ACUM, ELBA A (MD)
Entity Type:Individual
Prefix:DR
First Name:ELBA
Middle Name:A
Last Name:ORDUNA ACUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ESTANCIAS DEL PARQUE E 5 ST A
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-949-2011
Mailing Address - Fax:787-621-3328
Practice Address - Street 1:ROAD 2 KM 47.8 DOCTORS CENTER HOSP
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-3329
Practice Address - Fax:787-621-3328
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7438207R00000X, 207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD99621Medicare UPIN