Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 2290 | PR |
NPI | 1194871426 |
---|---|
Provider Name | Dr. Ana Evelyn Ayala |
First Address | Cidra, PR 00739-0209 |
Second Address | Cidra, PR 00739-3394 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2007 |
Last Update Date | 13/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4204AY | (02) | PR |
9260210 | (02) | PR |