Healthcare Provider Details

I. General information

NPI: 1154240935
Provider Name (Legal Business Name): PRISCILLA ALEXANDRA AYALA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 AVE PONCE DE LEON
SAN JUAN PR
00907-3367
US

IV. Provider business mailing address

902 AVE PONCE DE LEON
SAN JUAN PR
00907-3367
US

V. Phone/Fax

Practice location:
  • Phone: 787-478-0272
  • Fax:
Mailing address:
  • Phone: 787-478-0272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number6204
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: