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General NPI Number Information
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NPI Number | 1285611780
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Entity Type | Individual
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Provider Name | WILFREDO JOSE AVILES MD
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Gender | Male
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | PUERTA DEL SOL BUSINESS CENTER CARR. #2 SEGUNDO PISO OFICINA #1
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City | MANATI
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State | PR
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Zip | 00674
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Country | US
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Telephone | 787-884-2365
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Fax |
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Provider Business Mailing Address
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Address Line | URB. MONTE BELLO #775 ST. PETIRROJO
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City | DORADO
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State | PR
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Zip | 00646-9473
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Country | US
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Telephone | 787-242-4336
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 15483
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License Number State | PR
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