Healthcare Provider Details

I. General information

NPI: 1114821808
Provider Name (Legal Business Name): YAZMIN RAMOS AYALA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 149 KM 2.4 INT BO ARRIBA SALIENTE PUGNADO
MANATI PR
00674
US

IV. Provider business mailing address

F48 CALLE JUAN MORELL CAMPOS
MANATI PR
00674-6662
US

V. Phone/Fax

Practice location:
  • Phone: 787-908-6611
  • Fax:
Mailing address:
  • Phone: 787-908-6611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4867
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: