MEDICARE: DR. ROSANA AYALA REYES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	16025	PR

General Provider Information

NPI Number	:	1225083850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSANA AYALA REYES M.D.

Provider Business Mailing Address
First Line	:	VILLAS DE PARQUE ESCORIAL
Second Line	:	EDIFICIO G APART. 1501
City	:	CAROLINA
State	:	PR
Zip	:	00987
Country	:	US
Telephone Number	:	787-628-1404
Fax Number	:	787-200-5747

Provider Business Practice Location Address
First Line	:	VILLAS DE PARQUE ESCORIAL
Second Line	:	EDIFICIO G APARTA. 1501
City	:	CAROLINA
State	:	PR
Zip	:	00987
Country	:	US
Telephone Number	:	787-628-1401
Fax Number	:	787-200-5747

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	12/01/2025

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