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General NPI Number Information
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NPI Number | 1275654063
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Entity Type | Individual
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Provider Name | FREDDIE H. ROMAN AVILES M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/02/2021
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Provider Practice Location Address
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Address Line | 14 CALLE PERAL N OFICINA 1-E
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City | MAYAGUEZ
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State | PR
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Zip | 00680-4861
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Country | US
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Telephone | 787-833-1060
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Fax | 787-265-4025
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Provider Business Mailing Address
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Address Line | 14 CALLE PERAL N OFICINA 1-E
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City | MAYAGUEZ
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State | PR
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Zip | 00680-4861
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Country | US
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Telephone | 787-833-1060
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Fax | 787-265-4025
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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 | 3175
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License Number State | PR
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