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NPI Code Detail

MEDICARE: NICOLLE A AVILES

MEDICARE:   NICOLLE A 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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1982299905
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLLE A AVILES
Provider Business Mailing Address
First Line : 2777 10TH AVE N APT 305
Second Line :
City : PALM SPRINGS
State : FL
Zip : 33461-6750
Country : US
Telephone Number : 561-644-3995
Fax Number :
Provider Business Practice Location Address
First Line : 8895 N MILITARY TRL STE 300C
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33410-6279
Country : US
Telephone Number : 561-244-9499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2021
Last Update Date : 03/02/2021

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Directions to “ NICOLLE A AVILES ” Practice Location

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