Provider Demographics
NPI:1851035604
Name:PASCUAL AYALA, LIANA ALINA (RN)
Entity Type:Individual
Prefix:
First Name:LIANA
Middle Name:ALINA
Last Name:PASCUAL 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 1:9310 FONTAINEBLEAU BLVD APT 106
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4253
Mailing Address - Country:US
Mailing Address - Phone:305-297-3273
Mailing Address - Fax:
Practice Address - Street 1:9310 FONTAINEBLEAU BLVD APT 106
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4253
Practice Address - Country:US
Practice Address - Phone:305-297-3273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11019029363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000OtherI DON'T HAVE ANY