Jorge Acevedo Canabal, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

21568 Issued in PR

Practice address

115 Lighthouse Dr
Aguadilla, PR 00603-1327

Phone

(787) 403-5576

NPI assigned

Jul 31, 2016

Last updated

Sep 17, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1013460617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 CALLE 30",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009275209",
            "telephone_number": "787-403-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LIGHTHOUSE DR",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006031327",
            "telephone_number": "787-403-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEVEDO CANABAL",
        "first_name": "JORGE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-31",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlos Enrique Abreu Girald, DMD
• Pedro Antonio Abreu
• Veronica Abreu
• Jose A Acevedo Acevedo, M.D.
• Luis Antonio Acevedo Aquino, MD
• Lissette Acevedo Cruz, PSYD
• Luis G Acevedo Lazzarini, MD
• Gisela Acevedo Morales, MD
• Manuel Alejandro Acevedo Pena, MD
• Luis Enrique Acevedo Rodriguez

• General Practice Physician in Aguadilla, PR
• Providers in Aguadilla, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.