Healthcare Provider Details

I. General information

NPI: 1134747983
Provider Name (Legal Business Name): GENALEX HEALTH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2020
Last Update Date: 07/27/2020
Certification Date: 07/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB BAYAMON GARDENS AVENIDA CASTIGLIONI S4
BAYAMON PR
00956-0095
US

IV. Provider business mailing address

PO BOX 4009
BAYAMON PR
00958-1009
US

V. Phone/Fax

Practice location:
  • Phone: 787-797-6767
  • Fax: 787-797-7744
Mailing address:
  • Phone: 787-797-6767
  • Fax: 787-797-7744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EUGENIA AYALA-RIVERA
Title or Position: PEDIATRICIAN
Credential: MD
Phone: 787-447-2935