Healthcare Provider Details
I. General information
NPI: 1821925926
Provider Name (Legal Business Name): JLA INTERNAL MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
URB RIVIERA PARKVIEW 37 CALLE YOSEMITE
BAYAMON PR
00959
US
IV. Provider business mailing address
URB RIVIERA PARKVIEW 37 CALLE YOSEMITE
BAYAMON PR
00959
US
V. Phone/Fax
- Phone: 787-340-4167
- Fax:
- Phone: 787-340-4167
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOSE
AYALA RIVERA
Title or Position: OWNER
Credential: MD
Phone: 787-340-4167