MEDICARE: CARLOS JAVIER AYALA RODRIGUEZ MD

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	207RC0000X	Cardiovascular Disease Physician	23781	PR

General Provider Information

NPI Number	:	1174087878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS JAVIER AYALA RODRIGUEZ MD

Provider Business Mailing Address
First Line	:	F7 CALLE C
Second Line	:
City	:	HUMACAO
State	:	PR
Zip	:	00791-4221
Country	:	US
Telephone Number	:	787-224-8204
Fax Number	:

Provider Business Practice Location Address
First Line	:	F7 CALLE C
Second Line	:
City	:	HUMACAO
State	:	PR
Zip	:	00791-4221
Country	:	US
Telephone Number	:	787-224-8204
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2019
Last Update Date	:	02/25/2026

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