1508058777 NPI number — DR. SIGFREDO ACEVEDO CRUZ MD

Table of content: DR. SIGFREDO ACEVEDO CRUZ MD (NPI 1508058777)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508058777 NPI number — DR. SIGFREDO ACEVEDO CRUZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ACEVEDO CRUZ
Provider First Name:
SIGFREDO
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508058777
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 469
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SABANA HOYOS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00688-0469
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-669-1413
Provider Business Mailing Address Fax Number:
787-816-1028

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CAR 2 R639 K4 4 H5 INT
Provider Second Line Business Practice Location Address:
BO SABANA HOYOS SECTOR MENDEZ
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-699-1413
Provider Business Practice Location Address Fax Number:
787-816-1028
Provider Enumeration Date:
08/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  14986 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 393 . This is a "ACN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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