Provider Demographics
NPI:1144345315
Name:AVILES - RODRIGUEZ, TERESITA A (MD)
Entity type:Individual
Prefix:DR
First Name:TERESITA
Middle Name:A
Last Name:AVILES - RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 362875
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-2875
Mailing Address - Country:US
Mailing Address - Phone:787-777-3535
Mailing Address - Fax:787-773-0832
Practice Address - Street 1:CIRUGIA PEDIATRICA SEGUNDO PISO
Practice Address - Street 2:HOSPITAL PEDIATRICO UNIVERSITARIO, CENTRO MEDICO DE PR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935-0001
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:787-773-0832
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2014-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR45012086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery