Provider Demographics
NPI:1558344218
Name:AYALA, EVA A (LPN)
Entity Type:Individual
Prefix:MRS
First Name:EVA
Middle Name:A
Last Name:AYALA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 14551
Mailing Address - Street 2:TRUJILLO BAJO
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-9721
Mailing Address - Country:US
Mailing Address - Phone:787-767-7676
Mailing Address - Fax:787-764-9904
Practice Address - Street 1:AVENIDA 65 INFANTERIA KILOMETRO 3 4
Practice Address - Street 2:BARRIO SABANA LLANA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-767-7676
Practice Address - Fax:787-764-9904
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR23368164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse