MEDICARE: MR. ARMANDO AYALA REYES

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	163WG0000X	General Practice Registered Nurse	543737	PR

General Provider Information

NPI Number	:	1902261811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ARMANDO AYALA REYES

Provider Business Mailing Address
First Line	:	HC 1 BOX 2426
Second Line	:
City	:	COMERIO
State	:	PR
Zip	:	00782-9711
Country	:	US
Telephone Number	:	787-245-4410
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARR 167 # KM20.0
Second Line	:	APS HEALTHCARE BAYAMON
City	:	BAYAMON
State	:	PR
Zip	:	00961-6385
Country	:	US
Telephone Number	:	787-641-0774
Fax Number	:

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

Provider Enumeration Date	:	12/18/2015
Last Update Date	:	12/18/2015

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