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General NPI Number Information
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NPI Number | 1063612315
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Entity Type | Individual
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Provider Name | MR. ADOLFO AVILES
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Gender | Male
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 67 CALLE 65 INFANTERIA SUITE B 208
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City | ANASCO
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State | PR
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Zip | 00610-1670
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Country | US
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Telephone | 787-826-0770
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Fax | 787-826-3600
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Provider Business Mailing Address
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Address Line | P.O. BOX 758
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City | QUEBRADILLAS
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State | PR
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Zip | 00678
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Country | US
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Telephone | 787-895-8917
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Fax | 787-826-3600
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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 | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | TC-AMB-201
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License Number State | PR
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