Basic Information
| Provider Information | |||||||||
| NPI: | 1265017933 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARO FELICIANO | ||||||||
| FirstName: | AVELIN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | HC 2 BOX 22231 | ||||||||
| Address2: | |||||||||
| City: | AGUADILLA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006039050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9393394992 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | CALLE CONCEPCION VERA CARR 110 BARRIO PUEBLO | ||||||||
| Address2: | NUM 550 | ||||||||
| City: | MOCA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00676 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878778000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2021 | ||||||||
| LastUpdateDate: | 09/07/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 22961 | PR | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.