Provider Demographics
NPI:1366485427
Name:AVILES, NEREIDA (MSW)
Entity Type:Individual
Prefix:
First Name:NEREIDA
Middle Name:
Last Name:AVILES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CALLE SANTA CRUZ
Mailing Address - Street 2:D 303 COND. RIVER PARK
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-8500
Mailing Address - Country:US
Mailing Address - Phone:787-995-2700
Mailing Address - Fax:787-995-2706
Practice Address - Street 1:HOSTOS AVE.
Practice Address - Street 2:#435
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-995-2700
Practice Address - Fax:787-995-2706
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR37321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical