Provider Demographics
NPI:1659481323
Name:ACARON, SIFREDO III
Entity Type:Individual
Prefix:
First Name:SIFREDO
Middle Name:
Last Name:ACARON
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 2 D21
Mailing Address - Street 2:URB BORINQUEN
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623
Mailing Address - Country:US
Mailing Address - Phone:787-832-0040
Mailing Address - Fax:787-831-2616
Practice Address - Street 1:CALLE MOREL CAMPOS #4
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-832-0040
Practice Address - Fax:787-831-2616
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7458207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1656OtherPMCHOICE
601107OtherMMM
F20963Medicare UPIN
601107OtherMMM