Provider Demographics
NPI:1407926793
Name:AVILES-ROIG, CARLOS AUGUSTO (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:AUGUSTO
Last Name:AVILES-ROIG
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 1:10 CALLE AMARILLO
Mailing Address - Street 2:APT A, DE DIEGO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-3078
Mailing Address - Country:US
Mailing Address - Phone:787-767-0837
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE AMARILLO
Practice Address - Street 2:APT A DE DIEGO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-3078
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:787-641-9518
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry