Provider Demographics
NPI:1316925845
Name:ACEVEDO, BARBARA B (PA-C)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:B
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 41
Mailing Address - Street 2:BOX 4331
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09464-9998
Mailing Address - Country:US
Mailing Address - Phone:0798-616-7451
Mailing Address - Fax:
Practice Address - Street 1:48 MDG/SGOP
Practice Address - Street 2:UNIT 5210
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09464
Practice Address - Country:US
Practice Address - Phone:01144163-852-8559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1066573363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical