Provider Demographics
NPI:1144634874
Name:DR ERIC D AVILES RIVERA PSC
Entity type:Organization
Organization Name:DR ERIC D AVILES RIVERA PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:AVILES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-738-2200
Mailing Address - Street 1:BOX 6400
Mailing Address - Street 2:PMB 330
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-6400
Mailing Address - Country:US
Mailing Address - Phone:787-738-2200
Mailing Address - Fax:787-738-2200
Practice Address - Street 1:HOSPITAL MENONITA SUITE 207
Practice Address - Street 2:EDIFICIO PROFESIONAL
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-738-2200
Practice Address - Fax:787-738-2200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14628207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty