Provider Demographics
NPI:1619284437
Name:AYALA TORRES, JOSE ANTONIO JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANTONIO
Last Name:AYALA TORRES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1617
Mailing Address - Street 2:STREET 361 KM 1.4 INT CAIN ALTO
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-1617
Mailing Address - Country:US
Mailing Address - Phone:787-264-2995
Mailing Address - Fax:
Practice Address - Street 1:STREET . 361 KM 1.4 INT
Practice Address - Street 2:CAIN ALTO
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-1617
Practice Address - Country:US
Practice Address - Phone:787-264-2995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR18006208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice