Individual
MARY L. AVILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6474 VINELAND RD UNIT 207, ORLANDO, FL 32819-7879
(787) 346-6888
Mailing address
6474 VINELAND RD UNIT 207, ORLANDO, FL 32819-7879
(787) 346-6888
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09202103
—
FL
Enumeration date
03/16/2018
Last updated
03/16/2018
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