Provider Demographics
NPI:1972000883
Name:AYALA, FELIPE ANTONIO (MD)
Entity Type:Individual
Prefix:
First Name:FELIPE
Middle Name:ANTONIO
Last Name:AYALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7901 BROADWAY # D4-06
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1329
Mailing Address - Country:US
Mailing Address - Phone:347-949-3629
Mailing Address - Fax:
Practice Address - Street 1:260 STETSON STREET STETSON BUILDING SUITE 2300
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267-0816
Practice Address - Country:US
Practice Address - Phone:513-558-2968
Practice Address - Fax:513-558-4887
Is Sole Proprietor?:No
Enumeration Date:2018-04-07
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1454922084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology