Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME15590 | FL |
Y | 208D00000X | General Practice Physician | ME15590 | FL |
NPI | 1003901893 |
---|---|
Provider Name | Mr. Armando Enrique Acevedo |
First Address | Miami, FL 33142 |
Second Address | Miami, FL 33142 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 03/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100104200 | (05) | FL |
D59590 | (02) | FL |
ME0015590 | LICENSE (01) | FL |