Provider Demographics
NPI:1053751099
Name:HERNANDEZ AVILES, ANA SILVIA DEL SOCORRO (MD)
Entity type:Individual
Prefix:
First Name:ANA SILVIA
Middle Name:DEL SOCORRO
Last Name:HERNANDEZ AVILES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1327
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-1327
Mailing Address - Country:US
Mailing Address - Phone:603-524-3211
Mailing Address - Fax:603-527-7038
Practice Address - Street 1:724 N MAIN ST
Practice Address - Street 2:LACONIA CLINIC
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2742
Practice Address - Country:US
Practice Address - Phone:603-527-2711
Practice Address - Fax:603-528-1085
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH17338208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics