Johanna Acevedo, M.D.
Individual provider Active NPI General Practice Physician · Quebradillas, PR
NPI 1285873612 · NPPES record last updated Feb 9, 2009
Key facts
- NPI
- 1285873612
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 17328 (PR)
- Practice address
- HC 3 Box 16192
Quebradillas, PR 00678-9815 - Phone
- (787) 895-4995
- Fax
- (787) 262-2279
- NPI assigned
- Feb 9, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240930002260 | PR | Practitioner - General Practice | 5597986919 | Practice locations: Camuy, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 17328 | PR | Yes |
Addresses
Primary practice location
HC 3 Box 16192
Quebradillas, PR 00678-9815
Mailing address
HC 3 Box 16192
Quebradillas, PR 00678-9815
Phone (787) 895-4995
Other providers in Quebradillas, PR
- Jeshley Ann Abreu Ramos
- Michael Yobbany Acevedo Ranero
- Yessica Acevedo
- Eileene Adames-Mendez
- Advanced Medical Supply Corp
- Advanced Medical Supply,Corp.
- Eliz Alicea
All providers in Quebradillas, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.