Healthcare Provider Details

I. General information

NPI: 1134050040
Provider Name (Legal Business Name): JOSE J CENTENO AVILES PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 AVE LAURO PINERO
CEIBA PR
00735-2707
US

IV. Provider business mailing address

PO BOX 225
CEIBA PR
00735-0225
US

V. Phone/Fax

Practice location:
  • Phone: 787-885-2525
  • Fax:
Mailing address:
  • Phone: 787-885-2525
  • Fax: 787-885-2525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number008693
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: