Provider Demographics
NPI:1841226644
Name:ACEVEDO-URCUYO, ALICIA (MD)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:ACEVEDO-URCUYO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9305 W THOMAS RD STE 365
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-3367
Mailing Address - Country:US
Mailing Address - Phone:602-457-9915
Mailing Address - Fax:888-836-5765
Practice Address - Street 1:9305 W THOMAS RD STE 365
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3367
Practice Address - Country:US
Practice Address - Phone:602-457-9915
Practice Address - Fax:888-836-5765
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2025-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32996207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ870859Medicaid
AZ20-1226757OtherTAX ID#
AZ870859Medicaid