Provider Demographics
NPI:1346289659
Name:ACEVEDO, WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:ACEVEDO
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 1:6 CALLE TAPIA
Mailing Address - Street 2:OCEAN PARK
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911-1442
Mailing Address - Country:US
Mailing Address - Phone:787-641-2977
Mailing Address - Fax:787-641-5716
Practice Address - Street 1:6 CALLE TAPIA
Practice Address - Street 2:OCEAN PARK
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911-1442
Practice Address - Country:US
Practice Address - Phone:787-641-2977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10204208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation