Individual provider Active NPI

Kenneth Aviles Fernandez, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1912533787
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
24834 Issued in PR
Practice address
Avenida Ponce de Leon, Parada 37.5
San Juan, PR 00919
Phone
(787) 758-2000
NPI assigned
Mar 12, 2020
Last updated
Mar 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 24834 PR Primary

Addresses

Primary practice location

Avenida Ponce de Leon, Parada 37.5
San Juan, PR 00919

Mailing address

HC 3 Box 3628
Florida, PR 00650-9692
Phone (787) 949-2961

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

LicenseStateTypeSpecialty
24834PRMDGeneral Practice Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1912533787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 3 BOX 3628",
            "city": "FLORIDA",
            "state": "PR",
            "postal_code": "006509692",
            "telephone_number": "787-949-2961",
            "fax_number": "417-765-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVENIDA PONCE DE LEON, PARADA 37.5",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00919",
            "telephone_number": "787-758-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILES FERNANDEZ",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-12",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "24834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.