Provider Demographics
NPI:1902261811
Name:AYALA REYES, ARMANDO
Entity Type:Individual
Prefix:MR
First Name:ARMANDO
Middle Name:
Last Name:AYALA REYES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 2426
Mailing Address - Street 2:
Mailing Address - City:COMERIO
Mailing Address - State:PR
Mailing Address - Zip Code:00782-9711
Mailing Address - Country:US
Mailing Address - Phone:787-245-4410
Mailing Address - Fax:
Practice Address - Street 1:CARR 167 # KM20.0
Practice Address - Street 2:APS HEALTHCARE BAYAMON
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6385
Practice Address - Country:US
Practice Address - Phone:787-641-0774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR543737163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice