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General NPI Number Information
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NPI Number | 1053313353
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Entity Type | Individual
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Provider Name | OSVALDO AVILES VAZQUEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 03/03/2020
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Provider Practice Location Address
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Address Line | 35 LUIS MUNOZ RIVERA
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City | CABO ROJO
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State | PR
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Zip | 00623
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Country | US
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Telephone | 787-851-2555
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Fax | 787-851-1133
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Provider Business Mailing Address
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Address Line | EXTENSION MONTESOL 3004 CALLE YAUREL
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City | CABO ROJO
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State | PR
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Zip | 00623
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Country | US
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Telephone | 787-851-2555
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Fax | 787-851-1133
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 10059
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License Number State | PR
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