MEDICARE: YANIRA AVILES-BURGOS M.D.

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	207R00000X	Internal Medicine Physician	018349	PR

General Provider Information

NPI Number	:	1538316971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANIRA AVILES-BURGOS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 19325
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00910-1325
Country	:	US
Telephone Number	:	787-518-5304
Fax Number	:	787-936-7371

Provider Business Practice Location Address
First Line	:	1492 AVE PONCE DE LEON CENTRO EUROPA STE 104
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00909-0000
Country	:	US
Telephone Number	:	787-518-5304
Fax Number	:	787-936-7371

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	05/21/2024

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