Provider Demographics
NPI:1518197136
Name:AYALA RIOS, ROBERTO J (MD)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:J
Last Name:AYALA RIOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1750
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-1750
Mailing Address - Country:US
Mailing Address - Phone:787-370-6187
Mailing Address - Fax:787-826-7411
Practice Address - Street 1:65 DE INFANTERIA 67
Practice Address - Street 2:SUITE 104-109
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-826-2145
Practice Address - Fax:787-826-7411
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR17640208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice