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General NPI Number Information
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NPI Number | 1235268368
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Entity Type | Organization
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Legal Business Name | LOUIS AVILES MD PL
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 09/26/2007
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Provider Practice Location Address
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Address Line | 1007 JEFFORDS ST SUITE 102
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City | CLEARWATER
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State | FL
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Zip | 33756-4082
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Country | US
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Telephone | 727-447-9000
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Fax | 727-447-9255
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Provider Business Mailing Address
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Address Line | 1007 JEFFORDS ST SUITE 102
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City | CLEARWATER
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State | FL
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Zip | 33756-4082
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Country | US
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Telephone | 727-447-9000
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Fax | 727-447-9255
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LOUIS AVILES
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Credential | MD
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Telephone | 727-447-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME 65404
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License Number State | FL
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