Provider Demographics
NPI:1437463924
Name:AVILA, SYLVETTE MARIE
Entity Type:Individual
Prefix:MISS
First Name:SYLVETTE
Middle Name:MARIE
Last Name:AVILA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CONDOMINIO BRISAS II
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-3772
Mailing Address - Country:US
Mailing Address - Phone:787-462-1776
Mailing Address - Fax:787-995-5174
Practice Address - Street 1:RR 3 BOX 53051
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-6501
Practice Address - Country:US
Practice Address - Phone:787-462-1776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10241104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker