Healthcare Provider Details

I. General information

NPI: 1285370700
Provider Name (Legal Business Name): SOLMARIE AVILES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2022
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CALLE ANDRES MENDEZ LICIAGA
SAN SEBASTIAN PR
00685-2275
US

IV. Provider business mailing address

RR 1 BOX 44880
SAN SEBASTIAN PR
00685-6235
US

V. Phone/Fax

Practice location:
  • Phone: 787-896-1850
  • Fax:
Mailing address:
  • Phone: 787-213-7877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number10077
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number010077
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: