Provider Demographics
NPI:1225364003
Name:AVILES RAMIREZ, RAUL E (DC)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:E
Last Name:AVILES RAMIREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 HOSTOS AVE, MEDICAL EMPORIUM II
Mailing Address - Street 2:SUITE A33
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-265-4477
Mailing Address - Fax:
Practice Address - Street 1:349 HOSTOS AVE, MEDICAL EMPORIUM II
Practice Address - Street 2:SUITE A33
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-265-4477
Practice Address - Fax:888-872-7301
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR467111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor