Provider Demographics
NPI:1497763668
Name:ACEVEDO-FLORES, MIDNELA (MD)
Entity Type:Individual
Prefix:DR
First Name:MIDNELA
Middle Name:
Last Name:ACEVEDO-FLORES
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 1:215 PO BOX 70344
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8344
Mailing Address - Country:US
Mailing Address - Phone:178-776-5418
Mailing Address - Fax:178-775-1514
Practice Address - Street 1:PMB 215 70344
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-8344
Practice Address - Country:US
Practice Address - Phone:178-776-5418
Practice Address - Fax:178-775-1514
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8441208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR8334OtherM.D.