MEDICARE: RAJ PHYSIATRY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P0010X	Pediatric Rehabilitation Medicine Physician

General Provider Information

NPI Number	:	1073457354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAJ PHYSIATRY LLC

Provider Business Mailing Address
First Line	:	PO BOX 859
Second Line	:
City	:	GURABO
State	:	PR
Zip	:	00778-0859
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 AVE JOSE GARRIDO STE L-32
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00725-1943
Country	:	US
Telephone Number	:	787-746-3848
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICARDO ALEXIS AYALA JIMENEZ
Credential	:	MD
Telephone Number	:	787-341-0454

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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