MEDICARE: GISELA 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	104100000X	Social Worker	16545	PR

General Provider Information

NPI Number	:	1538322961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GISELA AVILES

Provider Business Mailing Address
First Line	:	1038 CALLE ALEJO CRUZADO
Second Line	:	URB COUNTRY CLUB
City	:	SAN JUAN
State	:	PR
Zip	:	00924-2469
Country	:	US
Telephone Number	:	787-998-5743
Fax Number	:

Provider Business Practice Location Address
First Line	:	AVE BARBOSA
Second Line	:	EDIF LINCOLN #414
City	:	SAN JUAN
State	:	PR
Zip	:	00928-1414
Country	:	US
Telephone Number	:	787-763-7575
Fax Number	:

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

Provider Enumeration Date	:	07/07/2008
Last Update Date	:	07/07/2008

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Directions to “ GISELA AVILES ” Practice Location

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