MEDICARE: JLA INTERNAL MEDICINE 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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1821925926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JLA INTERNAL MEDICINE LLC

Provider Business Mailing Address
First Line	:	URB RIVIERA PARKVIEW 37 CALLE YOSEMITE
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00959
Country	:	US
Telephone Number	:	787-340-4167
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB RIVIERA PARKVIEW 37 CALLE YOSEMITE
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00959
Country	:	US
Telephone Number	:	787-340-4167
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSE AYALA RIVERA
Credential	:	MD
Telephone Number	:	787-340-4167

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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