Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 18031 | PR |
N | 2081S0010X | Sports Medicine | 18031 | PR |
N | 213ES0000X | Sports Medicine | 18031 | PR |
NPI | 1205069275 |
---|---|
Provider Name | Rafael Acevedo |
First Address | Mayaguez, PR 00681-6216 |
Second Address | Hormigueros, PR 00660 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2009 |
Last Update Date | 06/09/2015 |