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General NPI Number Information
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NPI Number | 1659419810
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Entity Type | Individual
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Provider Name | CARLOS A AVILES GONZALEZ MD
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Gender | Male
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 03/20/2018
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Provider Practice Location Address
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Address Line | 187 AVE UNIVERSIDAD INTERAMERICANA EDIFICIO RALI SUITE 221
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City | SAN GERMAN
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State | PR
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Zip | 00683
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Country | US
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Telephone | 787-892-7044
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Fax | 787-892-7044
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Provider Business Mailing Address
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Address Line | BOX 5000 PMB 456
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City | SAN GERMAN
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State | PR
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Zip | 00683
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Country | US
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Telephone | 787-892-7044
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Fax | 787-892-7044
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 10058
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License Number State | PR
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