Provider Demographics
NPI:1972908259
Name:ORTIZ-ACEVEDO, MELVIN ENRIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:ENRIQUE
Last Name:ORTIZ-ACEVEDO
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:PO BOX 8901
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-8901
Mailing Address - Country:US
Mailing Address - Phone:787-852-1770
Mailing Address - Fax:787-266-7300
Practice Address - Street 1:57 CALLE FONT MARTELO W
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3615
Practice Address - Country:US
Practice Address - Phone:787-852-1770
Practice Address - Fax:787-266-7300
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18997208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRIC342AMedicare UPIN