Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 4501 | PR |
NPI | 1144345315 |
---|---|
Provider Name | Dr. Teresita A. Aviles - Rodriguez |
First Address | San Juan, PR 00936-2875 |
Second Address | San Juan, PR 00935-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 14/06/2014 |