Provider Demographics
NPI:1134168453
Name:AVILES, ANGEL
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:AVILES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:AVILES
Other - Middle Name:AMBULANCE
Other - Last Name:SERVICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1835 CALLE VICTOR CURBELO
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-2439
Mailing Address - Country:US
Mailing Address - Phone:787-895-7401
Mailing Address - Fax:787-818-0429
Practice Address - Street 1:1835 CALLE VICTOR CURBELO
Practice Address - Street 2:
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678-2439
Practice Address - Country:US
Practice Address - Phone:787-895-7401
Practice Address - Fax:787-818-0429
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 2573416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7747OtherAMERICAN HEALTH MEDICARE
PR7747OtherAMERICAN HEALTH MEDICARE