MEDICARE: ADOLFO AVILES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	TC-AMB-201	PR

General Provider Information

NPI Number	:	1235224585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADOLFO AVILES

Provider Business Mailing Address
First Line	:	65 CALLE 65 INFANTERIA
Second Line	:	SUITE 208
City	:	ANASCO
State	:	PR
Zip	:	00610-2909
Country	:	US
Telephone Number	:	787-826-0770
Fax Number	:	787-895-4630

Provider Business Practice Location Address
First Line	:	65 CALLE 65 INFANTERIA
Second Line	:	SUITE 208
City	:	ANASCO
State	:	PR
Zip	:	00610-2909
Country	:	US
Telephone Number	:	787-826-0770
Fax Number	:	787-895-4630

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ADOLFO AVILES
Credential	:
Telephone Number	:	787-826-0770

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/13/2007

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Directions to “ADOLFO AVILES ” Practice Location

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