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Individual

MR. YADIEL ACEVEDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1204 SHARED PASSION ST, RUSKIN, FL 33570-6379
(813) 516-9754
Mailing address
1204 SHARED PASSION ST, RUSKIN, FL 33570-6379
(813) 516-9754

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
CNA344974
FL
376K00000X
Nurse's Aide
Primary
CNA344974
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
18003778216
FL
Enumeration date
02/21/2017
Last updated
02/21/2017
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