Provider Demographics
NPI:1942958491
Name:ACEVEDO-MORALES, EPHRAIM (PHARMD, MPH)
Entity Type:Individual
Prefix:DR
First Name:EPHRAIM
Middle Name:
Last Name:ACEVEDO-MORALES
Suffix:
Gender:M
Credentials:PHARMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COUNTRY CLUB
Mailing Address - Street 2:MARIA B. BENITEZ 1145
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:URB PALMAS INDUSTRIAL PARK
Practice Address - Street 2:550 CALLE 869 KM 2.0
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-783-2245
Practice Address - Fax:787-781-8384
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6894183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist