Provider Demographics
NPI:1619042512
Name:ACEVEDO SOLIS, ZORAIDA IRENE (MS)
Entity Type:Individual
Prefix:
First Name:ZORAIDA
Middle Name:IRENE
Last Name:ACEVEDO SOLIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB 307
Mailing Address - Street 2:PO BOX 194000
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-4000
Mailing Address - Country:US
Mailing Address - Phone:787-948-7418
Mailing Address - Fax:
Practice Address - Street 1:200 JUNCOS PLZ
Practice Address - Street 2:SUITE 15
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-4222
Practice Address - Country:US
Practice Address - Phone:787-713-6505
Practice Address - Fax:787-713-6505
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR487231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
S28108Medicare UPIN