Most Relevant Information
Provider Data
| NPI Number: | 1003441841 |
| Provider Name: | EDDA COLON AVILES |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/11/2020 |
| Last Updated: | 03/11/2020 |
Provider Practice Location
1239 E MAIN ST
BARTOW
FL
338305058
Practice Location Phone/Fax
| Phone: | 8635190575 |
| Fax: | 8635829251 |
Provider Mailing Location
PO BOX 1559
BARTOW
FL
338311559
Provider Mailing Phone/Fax
| Phone: | 8635190575 |
| Fax: | 8635829251 |