Provider Demographics
NPI:1508815325
Name:JUSTO AYALA ARES
Entity Type:Organization
Organization Name:JUSTO AYALA ARES
Other - Org Name:AYALAS MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTO
Authorized Official - Middle Name:N
Authorized Official - Last Name:AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-447-7666
Mailing Address - Street 1:PMB 331 BOX 6017
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-6017
Mailing Address - Country:US
Mailing Address - Phone:787-447-7666
Mailing Address - Fax:787-776-1085
Practice Address - Street 1:CALLE 45 I-1 EXT PARQUE CUESTRE
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00984
Practice Address - Country:US
Practice Address - Phone:787-447-7666
Practice Address - Fax:787-776-1085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 2813416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0056874Medicare ID - Type UnspecifiedAMBULANCE LAND