Provider Demographics
NPI:1366947459
Name:CUEVAS ACEVEDO, DARILYS MARIE
Entity type:Individual
Prefix:
First Name:DARILYS
Middle Name:MARIE
Last Name:CUEVAS ACEVEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 AVE SAN IGNACIO APTO 206 CONDOMINIO VISTA VERDE
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-3815
Mailing Address - Country:US
Mailing Address - Phone:787-487-3752
Mailing Address - Fax:
Practice Address - Street 1:65 INFANTERIA SHOPPING CTR SUITE 101 SAN JUAN, PR 00925
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925
Practice Address - Country:US
Practice Address - Phone:787-767-1636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist