Provider Demographics
NPI:1326149121
Name:ACEVEDO RODRIGUEZ, LUIS FRANCISCO (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:FRANCISCO
Last Name:ACEVEDO RODRIGUEZ
Suffix:
Gender:M
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:Q-341 TULIPAN STREET
Mailing Address - Street 2:LOMAS DE LA SERRANIA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-438-3171
Mailing Address - Fax:
Practice Address - Street 1:CALLE - E, PLAZA GUAYNABO
Practice Address - Street 2:EDIF. CARIBBEAN CINEMAS, STE 201
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-731-4949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14773207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR14773OtherSTATE MEDICAL LIC.
PRDM13846-1OtherASSMCA
PRBA8256302OtherDEA