| Doctor Name: | JAIME L DE LA CRUZ AVILES |
| NPI Number: | 1649475708 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD MEDICAL DOCTOR |
| License Number: | 5049 |
| Business Practice Address: | Calle Carazo #136 Guaynabo, PR - 00969 |
| Business Phone Number: | 7877206326 |
| Business Fax Number: | |
| Mailing Address: | Po Box 362072, SAN JUAN |
| State: | PR |
| Postal Code: | 009362072 |
| Phone Number: | 7877206326 |
| Fax Number: | |
| NPI Enumeration Date: | 06/19/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5049 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |