Provider Demographics
NPI:1811020605
Name:AYALA MOLINA, LILLIAN J (BSW)
Entity Type:Individual
Prefix:MRS
First Name:LILLIAN
Middle Name:J
Last Name:AYALA MOLINA
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB LAS CAMPINAS II 64 CLAMISTAD
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:787-736-0575
Practice Address - Street 1:ANE MUNOZ RIVERIA FINAL PLAZA BUZ
Practice Address - Street 2:
Practice Address - City:SAN LORENZ
Practice Address - State:PR
Practice Address - Zip Code:00754
Practice Address - Country:US
Practice Address - Phone:787-736-3655
Practice Address - Fax:787-736-0575
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28390163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care