Provider Demographics
NPI:1497881189
Name:AYALA, ELVIA ARELIS (MD)
Entity type:Individual
Prefix:MRS
First Name:ELVIA
Middle Name:ARELIS
Last Name:AYALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5256
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-5256
Mailing Address - Country:US
Mailing Address - Phone:787-891-6230
Mailing Address - Fax:
Practice Address - Street 1:BO BORINQUEN CARR. 107
Practice Address - Street 2:LOCAL #2
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-891-6230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14515261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI26991Medicare UPIN
PR0023032Medicare ID - Type Unspecified