Provider Demographics
NPI:1770732828
Name:IVAN AYALA, CARDIOLOGIA Y ALGO MAS, C.S.P.
Entity type:Organization
Organization Name:IVAN AYALA, CARDIOLOGIA Y ALGO MAS, C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-781-0250
Mailing Address - Street 1:PO BOX 193222
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-3222
Mailing Address - Country:US
Mailing Address - Phone:787-781-0250
Mailing Address - Fax:787-749-0826
Practice Address - Street 1:100 CALLE 31 SW # URB
Practice Address - Street 2:U3-8 CARR 21
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-2402
Practice Address - Country:US
Practice Address - Phone:787-781-0250
Practice Address - Fax:787-749-0826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-13
Last Update Date:2008-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9949207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty