Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 19672 | PR |
N | 2084N0402X | Child Neurologist | 19672 | PR |
NPI | 1174938195 |
---|---|
Provider Name | Alexandra M Montalvo Acevedo |
First Address | San Juan, PR 00927-6211 |
Second Address | San Juan, PR 00912-3240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2014 |
Last Update Date | 29/10/2021 |