1881658284 NPI number — DR. ALFREDO AYALA MARRERO MD

Table of content: DR. ALFREDO AYALA MARRERO MD (NPI 1881658284)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881658284 NPI number — DR. ALFREDO AYALA MARRERO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AYALA MARRERO
Provider First Name:
ALFREDO
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881658284
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CAMINO DE LOS COHITRES #102
Provider Second Line Business Mailing Address:
SABANERA DORADO
Provider Business Mailing Address City Name:
DORADO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00646
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-287-1921
Provider Business Mailing Address Fax Number:
787-869-6611

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVENIDA DE DIEGO 150
Provider Second Line Business Practice Location Address:
SAN JUAN HEALTH CENTRE SUITE 201
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-230-7557
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  7230 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 28721 . This is a "SSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 400054 . This is a "MMM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7190017 . This is a "HURNMA" identifier . This identifiers is of the category "OTHER".
  • Identifier: M000240 . This is a "H MENONITA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660452859 . This is a "CASUI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 17230 . This is a "MCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2683A . This is a "PREFERRED MEDICAL OFFICE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com