Provider Demographics
NPI:1376238634
Name:ACEVEDO, RAIMUNDO
Entity Type:Individual
Prefix:
First Name:RAIMUNDO
Middle Name:
Last Name:ACEVEDO
Suffix:
Gender:M
Credentials:
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 959
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0959
Mailing Address - Country:US
Mailing Address - Phone:787-995-5200
Mailing Address - Fax:787-995-5189
Practice Address - Street 1:AVE. LAUREL, ESQ. AVE. LOS MILLONES
Practice Address - Street 2:URB. SANTA JUANITA,
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-995-5200
Practice Address - Fax:787-995-5189
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist