Provider Demographics
NPI:1528044641
Name:AYALA, MAIRA (MD)
Entity Type:Individual
Prefix:DR
First Name:MAIRA
Middle Name:
Last Name:AYALA
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:RD 8177 TORRE DE LOS FRAILES CONDO
Mailing Address - Street 2:APT 1J
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-635-7393
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE CARAZO
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5639
Practice Address - Country:US
Practice Address - Phone:787-789-8417
Practice Address - Fax:787-789-8417
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR102432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry