Provider Demographics
NPI:1487350153
Name:AYALA, RICARDO JOAQUIN (APRN - FNP)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:JOAQUIN
Last Name:AYALA
Suffix:
Gender:M
Credentials:APRN - FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8295 CADRE NOIR RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-6703
Mailing Address - Country:US
Mailing Address - Phone:561-805-0328
Mailing Address - Fax:
Practice Address - Street 1:5352 LINTON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6514
Practice Address - Country:US
Practice Address - Phone:561-498-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11021945363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily