Provider Demographics
NPI:1891401253
Name:ACEVEDO-VALLE, NELVIN (MD)
Entity type:Individual
Prefix:DR
First Name:NELVIN
Middle Name:
Last Name:ACEVEDO-VALLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB ROLLIN HILLS CALLE ESTADOS UNIDOS
Mailing Address - Street 2:F190 SEGUNDO PISO
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00986
Mailing Address - Country:US
Mailing Address - Phone:939-224-5667
Mailing Address - Fax:
Practice Address - Street 1:URB ROLLIN HILLS CALLE ESTADOS UNIDOS
Practice Address - Street 2:F190 SEGUNDO PISO
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00986
Practice Address - Country:US
Practice Address - Phone:939-224-5667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
PR24240208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program