Individual
DR. LUIS EDUARDO AVILES-LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
(239) 658-3011
(239) 658-3070
Mailing address
1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
(239) 658-3011
(239) 658-3070
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD15467R
LA
208000000X
Pediatrics Physician
Primary
ME59851
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1468134
—
LA
05
—
371593100
—
FL
Enumeration date
07/25/2007
Last updated
11/03/2011
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