MEDICARE: DR. OSVALDO AVILES VAZQUEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	10059	PR

General Provider Information

NPI Number	:	1053313353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OSVALDO AVILES VAZQUEZ M.D.

Provider Business Mailing Address
First Line	:	EXTENSION MONTESOL 3004
Second Line	:	CALLE YAUREL
City	:	CABO ROJO
State	:	PR
Zip	:	00623
Country	:	US
Telephone Number	:	787-851-2555
Fax Number	:	787-851-1133

Provider Business Practice Location Address
First Line	:	35 LUIS MUNOZ RIVERA
Second Line	:
City	:	CABO ROJO
State	:	PR
Zip	:	00623
Country	:	US
Telephone Number	:	787-851-2555
Fax Number	:	787-851-1133

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	03/03/2020

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