Provider Demographics
NPI:1619052420
Name:AVILES, LEYZA ENID (MD)
Entity Type:Individual
Prefix:
First Name:LEYZA
Middle Name:ENID
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:CALLE ASIS 680
Mailing Address - Street 2:URB CRUDAD REAL
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-346-7100
Mailing Address - Fax:787-858-3700
Practice Address - Street 1:CALLE PASEO 81
Practice Address - Street 2:AVENIDA VILLA PINARES
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-858-1111
Practice Address - Fax:787-858-3700
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15529207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine