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General NPI Number Information
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NPI Number | 1598152571
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Entity Type | Individual
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Provider Name | SHARLENE MEDINA AVILES M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/17/2015
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 917 AVE TITO CASTRO STE 814
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City | PONCE
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State | PR
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Zip | 00716-4717
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Country | US
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Telephone | 787-455-0498
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 464
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City | MERCEDITA
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State | PR
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Zip | 00715-0464
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Country | US
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Telephone | 787-455-0498
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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 | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 19657
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License Number State | PR
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