Provider Demographics
NPI:1104839596
Name:AVILES HERNANDEZ, ISRAEL (MD)
Entity Type:Individual
Prefix:
First Name:ISRAEL
Middle Name:
Last Name:AVILES HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2439
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-2439
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARR 2, KM 81, MARGINAL, REPARTO SAN MIGUEL
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-1299
Practice Address - Country:US
Practice Address - Phone:787-878-4143
Practice Address - Fax:787-879-4143
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR147772081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine