Provider Demographics
NPI:1558797274
Name:AYALA-CAMINERO, AUGUSTO JOSE (MD)
Entity Type:Individual
Prefix:
First Name:AUGUSTO
Middle Name:JOSE
Last Name:AYALA-CAMINERO
Suffix:
Gender:M
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:VIA DEL RIO # 41
Mailing Address - Street 2:ENCANTADA, PARQUE DEL RIO
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-585-2411
Mailing Address - Fax:
Practice Address - Street 1:ENCANTADA PLZ
Practice Address - Street 2:PARQUE DEL RIO, VIA DEL RIO # 41
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-6301
Practice Address - Country:US
Practice Address - Phone:787-585-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18582207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine