Provider Demographics
NPI:1538677851
Name:ACEVEDO, LUISA ESTHER (MD)
Entity Type:Individual
Prefix:DR
First Name:LUISA
Middle Name:ESTHER
Last Name:ACEVEDO
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:PO BOX 686
Mailing Address - Street 2:
Mailing Address - City:PATILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00723-0686
Mailing Address - Country:US
Mailing Address - Phone:787-383-5529
Mailing Address - Fax:
Practice Address - Street 1:6 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723-2606
Practice Address - Country:US
Practice Address - Phone:787-383-5529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19834208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice