Provider Demographics
NPI:1093818924
Name:AVILES, ERIC DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:DAVID
Last Name:AVILES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6400
Mailing Address - Street 2:PMB330
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737
Mailing Address - Country:US
Mailing Address - Phone:787-738-2200
Mailing Address - Fax:
Practice Address - Street 1:EDIFICIO PROFESIONAL HOSPITAL MENONITE
Practice Address - Street 2:SUITE # 207
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00973
Practice Address - Country:US
Practice Address - Phone:787-738-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14628207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease