Provider Demographics
NPI:1033009055
Name:ACEVEDO, MIGUEL RODRIGUEZ
Entity type:Individual
Prefix:
First Name:MIGUEL
Middle Name:RODRIGUEZ
Last Name:ACEVEDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4526 S 33RD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-1423
Mailing Address - Country:US
Mailing Address - Phone:402-206-7559
Mailing Address - Fax:
Practice Address - Street 1:4526 S 33RD ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-1423
Practice Address - Country:US
Practice Address - Phone:402-206-7559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider