Provider Demographics
NPI:1487860318
Name:AVILES, MILIGSA (MD)
Entity Type:Individual
Prefix:
First Name:MILIGSA
Middle Name:
Last Name:AVILES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 VILLA BLANCA
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-7125
Mailing Address - Country:US
Mailing Address - Phone:787-805-3457
Mailing Address - Fax:
Practice Address - Street 1:5 VILLA BLANCA
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-7125
Practice Address - Country:US
Practice Address - Phone:787-805-3457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12504208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice