Provider Demographics
NPI:1821491291
Name:TORRES-AYALA, STEPHANIE CLAUDETTE
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:CLAUDETTE
Last Name:TORRES-AYALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6026
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-6026
Mailing Address - Country:US
Mailing Address - Phone:787-464-9870
Mailing Address - Fax:
Practice Address - Street 1:HC 5 BOX 50873
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-9482
Practice Address - Country:US
Practice Address - Phone:787-464-9870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR0218332085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program