Provider Demographics
NPI:1780660696
Name:POMALES AYALA, ANA M (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:M
Last Name:POMALES AYALA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PLAZA LOS ALMENDROS
Mailing Address - Street 2:APT 1002 TORRE II
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:787-767-7676
Mailing Address - Fax:787-764-9904
Practice Address - Street 1:AVE 65 INFANTERIA K 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:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28089163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
407004Medicare ID - Type Unspecified