Provider Demographics
NPI:1700549813
Name:AYALA, ELIZABETH (CRNI, RN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:AYALA
Suffix:
Gender:F
Credentials:CRNI, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3085 W 80TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-3888
Mailing Address - Country:US
Mailing Address - Phone:305-863-4277
Mailing Address - Fax:
Practice Address - Street 1:3085 W 80TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-3888
Practice Address - Country:US
Practice Address - Phone:305-863-4277
Practice Address - Fax:305-863-4277
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9179794163WI0500X, 163WI0600X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control