Provider Demographics
NPI:1063673598
Name:ALFREDO AYALA Y ASOCIADOS
Entity Type:Organization
Organization Name:ALFREDO AYALA Y ASOCIADOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:AYALA-MERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-278-1921
Mailing Address - Street 1:PO BOX 51595
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-1595
Mailing Address - Country:US
Mailing Address - Phone:787-772-8199
Mailing Address - Fax:787-772-8199
Practice Address - Street 1:GEORGETTI #139
Practice Address - Street 2:
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719
Practice Address - Country:US
Practice Address - Phone:787-869-0490
Practice Address - Fax:787-869-6611
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALFREDO AYALA Y ASOCIADOS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7230208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
028721Medicare PIN