MEDICARE: SOFIA MARIA AYALA SILVA OTR/L

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	225X00000X	Occupational Therapist	1361	PR

General Provider Information

NPI Number	:	1982488912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOFIA MARIA AYALA SILVA OTR/L

Provider Business Mailing Address
First Line	:	BB24 CALLE CASTILLA
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00983-1904
Country	:	US
Telephone Number	:	787-247-0302
Fax Number	:

Provider Business Practice Location Address
First Line	:	1260 CALLE 54 SE
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00921-3143
Country	:	US
Telephone Number	:	787-999-5538
Fax Number	:

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

Provider Enumeration Date	:	08/21/2023
Last Update Date	:	08/26/2023

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