Provider Demographics
NPI:1639241961
Name:DELGADO AYALA, ROSA MARIA (MD)
Entity Type:Individual
Prefix:MISS
First Name:ROSA
Middle Name:MARIA
Last Name:DELGADO 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:URBANIZACION SAN ANTONIO E-23 CALLE 4
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-3704
Mailing Address - Country:US
Mailing Address - Phone:787-285-6973
Mailing Address - Fax:
Practice Address - Street 1:CLINICA INMUNOLOGIA REGIONAL AVE TITO CASTRO # 917
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00731
Practice Address - Country:US
Practice Address - Phone:787-259-4731
Practice Address - Fax:787-259-3998
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4304208000000X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR83488 D-EOtherSSS