Provider Demographics
NPI:1619090289
Name:AYALA, RITA C (DDS)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:C
Last Name:AYALA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 SW 121ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2061
Mailing Address - Country:US
Mailing Address - Phone:305-271-8299
Mailing Address - Fax:305-387-6566
Practice Address - Street 1:9280 HAMMOCKS BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1594
Practice Address - Country:US
Practice Address - Phone:305-387-5700
Practice Address - Fax:305-387-6566
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0014821122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist