Provider Demographics
NPI:1013339423
Name:AYALA, YAMIRA
Entity Type:Individual
Prefix:
First Name:YAMIRA
Middle Name:
Last Name: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 1:6150 METROWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-3289
Mailing Address - Country:US
Mailing Address - Phone:407-730-3837
Mailing Address - Fax:407-730-3869
Practice Address - Street 1:6150 METROWEST BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3289
Practice Address - Country:US
Practice Address - Phone:407-730-3837
Practice Address - Fax:407-730-3869
Is Sole Proprietor?:No
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist