Provider Demographics
NPI:1225083850
Name:AYALA REYES, ROSANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSANA
Middle Name:
Last Name:AYALA REYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VILLAS DE PARQUE ESCORIAL
Mailing Address - Street 2:EDIFICIO G APART. 1501
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-628-1404
Mailing Address - Fax:787-200-5747
Practice Address - Street 1:VILLAS DE PARQUE ESCORIAL
Practice Address - Street 2:EDIFICIO G APARTA. 1501
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-628-1401
Practice Address - Fax:787-200-5747
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16025208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice