Provider Demographics
NPI:1730147927
Name:RIOS AVILES, LYLKA (OD)
Entity type:Individual
Prefix:DR
First Name:LYLKA
Middle Name:
Last Name:RIOS AVILES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 CARR 152
Mailing Address - Street 2:SUITE 14
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-3808
Mailing Address - Country:US
Mailing Address - Phone:787-869-4242
Mailing Address - Fax:787-869-2804
Practice Address - Street 1:615 CARR 152
Practice Address - Street 2:SUITE 14
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-3808
Practice Address - Country:US
Practice Address - Phone:787-869-4242
Practice Address - Fax:787-869-2804
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR459152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR215118OtherPREFERRED HEALTH
PR890296OtherMEDICARE Y MUCHO MAS
PR58166OtherTRIPLE S REFORMA
PR2200093OtherHUMANA REFORMA
PR7695OtherIMC (INT MED CARD)
PR077121OtherCRUZ AZUL DE PUERTO RICO
PR077121OtherCRUZ AZUL DE PUERTO RICO