Provider Demographics
NPI:1508498585
Name:ACOSTA, ARACELY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ARACELY
Middle Name:
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MR
Other - First Name:ARACELY
Other - Middle Name:
Other - Last Name:ACOSTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:COND EL LAUREL
Mailing Address - Street 2:J-8 AVE. SAN PATRICIO # 36
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968
Mailing Address - Country:US
Mailing Address - Phone:787-783-4510
Mailing Address - Fax:787-792-0831
Practice Address - Street 1:1484 AVE. F.D. ROOSEVELT
Practice Address - Street 2:SUITE 19
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920
Practice Address - Country:US
Practice Address - Phone:787-783-4510
Practice Address - Fax:787-792-0831
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR30391835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care