Provider Demographics
NPI:1053453514
Name:CABAN, ANA A AVILES (PROF)
Entity Type:Individual
Prefix:PROF
First Name:ANA A
Middle Name:AVILES
Last Name:CABAN
Suffix:
Gender:F
Credentials:PROF
Other - Prefix:PROF
Other - First Name:ANA A
Other - Middle Name:AVILES
Other - Last Name:CABAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PROF
Mailing Address - Street 1:MIGRANT HEALTH CENTER, INC.
Mailing Address - Street 2:P O BOX 7128
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-7128
Mailing Address - Country:US
Mailing Address - Phone:787-805-2900
Mailing Address - Fax:787-834-1924
Practice Address - Street 1:MIGRANT HEALTH CENTER, INC.
Practice Address - Street 2:392 SUR CALLE RAMON EMETERIO BETANCES
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-805-2900
Practice Address - Fax:787-834-1924
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR325133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist