MEDICARE: DAYANA ALEJANDRA AYALA

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	224Z00000X	Occupational Therapy Assistant	19178	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	19178	OTHER	FL	THERAPY LICENSE

General Provider Information

NPI Number	:	1316654957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAYANA ALEJANDRA AYALA

Provider Business Mailing Address
First Line	:	11777 SW 18TH ST APT 6
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-1626
Country	:	US
Telephone Number	:	954-299-2216
Fax Number	:

Provider Business Practice Location Address
First Line	:	11777 SW 18TH ST APT 6
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-1626
Country	:	US
Telephone Number	:	954-299-2216
Fax Number	:

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

Provider Enumeration Date	:	11/02/2022
Last Update Date	:	11/02/2022

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