Provider Demographics
NPI:1285370700
Name:AVILES, SOLMARIE
Entity type:Individual
Prefix:
First Name:SOLMARIE
Middle Name:
Last Name:AVILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 44880
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-6235
Mailing Address - Country:US
Mailing Address - Phone:787-213-7877
Mailing Address - Fax:
Practice Address - Street 1:3 CALLE ANDRES MENDEZ LICIAGA
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2275
Practice Address - Country:US
Practice Address - Phone:787-896-1850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-08
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10077183700000X
PR010077183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician