Provider Demographics
NPI:1912532011
Name:ACEVEDO GUZMAN, ALEXANDRA MARIA (DC)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:MARIA
Last Name:ACEVEDO GUZMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C58 CALLE MARACAIBO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2254
Mailing Address - Country:US
Mailing Address - Phone:787-525-5554
Mailing Address - Fax:
Practice Address - Street 1:504 AVE HOSTOS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3231
Practice Address - Country:US
Practice Address - Phone:787-525-5554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-09
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR710111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty