Basic Information
| Provider Information | |||||||||
| NPI: | 1255317921 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AYALA | ||||||||
| FirstName: | ISRAEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 CALLE GLORIMAR | ||||||||
| Address2: | JARDINES CALDAS RIO PIEDRAS | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009265316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7873856740 | ||||||||
| FaxNumber: | 7872514518 | ||||||||
| Practice Location | |||||||||
| Address1: | ADMINISTRACION DE SERVICIOS MEDICOS | ||||||||
| Address2: | BOX 2129 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877773483 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 5546 | PR | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.