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General NPI Number Information
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NPI Number | 1881658284
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Entity Type | Individual
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Provider Name | ALFREDO AYALA MARRERO MD
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Gender | Male
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | AVENIDA DE DIEGO 150 SAN JUAN HEALTH CENTRE SUITE 201
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City | SAN JUAN
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State | PR
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Zip | 00907
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Country | US
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Telephone | 787-230-7557
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Fax |
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Provider Business Mailing Address
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Address Line | CAMINO DE LOS COHITRES #102 SABANERA DORADO
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City | DORADO
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State | PR
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Zip | 00646
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Country | US
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Telephone | 787-287-1921
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Fax | 787-869-6611
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 7230
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License Number State | PR
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