Active NPI
Cristobal Antron Avila, M.D
- General Practice Physician
- Luquillo, PR
National Provider Identifier
1205039104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 10988
- Practice address
- Urb. Brisas del Mar
Edificio Sonny City Calle 2-J-6
Luquillo, PR 00738-0005 - Phone
- (939) 640-6095
- Fax
- (787) 888-0202
- NPI assigned
- Jun 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 10988 | PR | Primary |
Addresses
Primary practice location
Urb. Brisas del Mar
Edificio Sonny City Calle 2-J-6
Luquillo, PR 00738-0005
Mailing address
PMB 108 PO. Box 70005
Fajardo, PR 00738-0005
Phone (787) 887-1819
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10988 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267574400000",
"number": "1205039104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PMB 108 PO. BOX 70005",
"city": "FAJARDO",
"state": "PR",
"postal_code": "007380005",
"telephone_number": "787-887-1819",
"fax_number": "787-888-0202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "URB. BRISAS DEL MAR",
"address_2": "EDIFICIO SONNY CITY CALLE 2-J-6",
"city": "LUQUILLO",
"state": "PR",
"postal_code": "007380005",
"telephone_number": "939-640-6095",
"fax_number": "787-888-0202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTRON AVILA",
"first_name": "CRISTOBAL",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-07",
"last_updated": "2010-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "10988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Luquillo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.