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MR. JORGE ACEVEDO CANABAL

>> Organized Health Care Education/Training Program >> Student

Registrant NPI Number: 1013460617

Individual Registrant:
MR. JORGE  ACEVEDO CANABAL 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
115 LIGHTHOUSE DR  AGUADILLA, PR 00603-1327 US
Tel: 787-403-5576  Fax: --

Contact information for business:
115 LIGHTHOUSE DR  AGUADILLA, PR 00603-1327 US
Tel: 787-403-5576  Fax: --

Registration Information:
NPI: 1013460617
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y390200000XStudent
Organized Health Care Education/Training Program
PR4700471

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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