Provider Demographics
NPI:1114483948
Name:AVILES-ROBLES, CHRISTIAN JULIAN (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:JULIAN
Last Name:AVILES-ROBLES
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:E1 CALLE FELIPE PRIMERO
Mailing Address - Street 2:MANSIONES REALES
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-948-6981
Mailing Address - Fax:
Practice Address - Street 1:E1 CALLE FELIPE PRIMERO
Practice Address - Street 2:MANSIONES REALES
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-948-6981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14921-I208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice