Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 864 | PR |
NPI | 1033212501 |
---|---|
Provider Name | Dr. Victor L Acevedo |
First Address | San Juan, PR 00923-3306 |
Second Address | San Juan, PR 00923-3306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040376 | CRUZ AZUL DE PR (01) | PR |
42261 | TRIPLE S, INC (01) | PR |
8817007 | UNITED CONCORDIA (01) | PR |