Provider Demographics
NPI:1831309731
Name:AVILES, ALBA N (OT)
Entity Type:Individual
Prefix:MRS
First Name:ALBA
Middle Name:N
Last Name:AVILES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 CALLE TORONTO
Mailing Address - Street 2:ESTANCIAS DE TORTUGUERO
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-3638
Mailing Address - Country:US
Mailing Address - Phone:787-399-0515
Mailing Address - Fax:
Practice Address - Street 1:233 CALLE TORONTO
Practice Address - Street 2:ESTANCIAS DE TORTUGUERO
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-3638
Practice Address - Country:US
Practice Address - Phone:787-854-1426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR663225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist