Provider Demographics
NPI:1104612795
Name:ORTIZ-ACEVEDO, LILLIANA (PHARMD)
Entity type:Individual
Prefix:
First Name:LILLIANA
Middle Name:
Last Name:ORTIZ-ACEVEDO
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB 939 BOX 2500
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00951
Mailing Address - Country:US
Mailing Address - Phone:787-261-9191
Mailing Address - Fax:
Practice Address - Street 1:CARR 865 KM 4.3 # 88
Practice Address - Street 2:BO. CANDELARIA ARENA
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00951
Practice Address - Country:US
Practice Address - Phone:787-261-9191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist