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NPI Code Detail

MEDICARE: DR. ANTENOR XAVIER AVILES MD

MEDICARE: DR. ANTENOR XAVIER AVILES MD
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
1207Q00000XFamily Medicine Physician35191RPR
2207Q00000XFamily Medicine PhysicianME154019FL
3207QG0300XGeriatric Medicine (Family Medicine) Physician65267AZ
4207QG0300XGeriatric Medicine (Family Medicine) PhysicianME154019FL
5207Q00000XFamily Medicine Physician65267AZ

General Provider Information

NPI Number : 1528668720
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTENOR XAVIER AVILES MD
Provider Business Mailing Address
First Line : 102 WOODMONT BLVD STE 600
Second Line :
City : NASHVILLE
State : TN
Zip : 37205-5250
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4420 E MCDOWELL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-4504
Country : US
Telephone Number : 602-858-4295
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2020
Last Update Date : 08/07/2024

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