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General NPI Number Information
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NPI Number | 1528668720
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Entity Type | Individual
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Provider Name | ANTENOR XAVIER AVILES MD
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Gender | Male
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 4420 E MCDOWELL RD
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City | PHOENIX
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State | AZ
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Zip | 85008-4504
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Country | US
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Telephone | 602-858-4295
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Fax |
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Provider Business Mailing Address
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Address Line | 102 WOODMONT BLVD STE 600
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City | NASHVILLE
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State | TN
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Zip | 37205-5250
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Country | US
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Telephone |
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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 | 35191R
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME154019
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 65267
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | ME154019
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 65267
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License Number State | AZ
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