Provider Demographics
NPI:1558590224
Name:ACEVEDO HERNANDEZ, ALEJANDRO LUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:LUIS
Last Name:ACEVEDO HERNANDEZ
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 1:1485-2 AVE ASHFORD
Mailing Address - Street 2:APT 1402
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1553
Mailing Address - Country:US
Mailing Address - Phone:787-307-9557
Mailing Address - Fax:
Practice Address - Street 1:100 CARR 165 STE 311
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-8050
Practice Address - Country:US
Practice Address - Phone:787-307-9557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-02
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1480792084P0800X
PR185982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry