Provider Demographics
NPI:1235863275
Name:AVILES-ACOSTA, JOSE FRANCISCO (PSYD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:FRANCISCO
Last Name:AVILES-ACOSTA
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 CALLE AMAPOLA
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-9011
Mailing Address - Country:US
Mailing Address - Phone:787-514-6442
Mailing Address - Fax:
Practice Address - Street 1:231 CALLE AMAPOLA
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-9011
Practice Address - Country:US
Practice Address - Phone:787-514-6442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08282103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical