Enid Cruz Ayala

Individual provider Active NPI Physician Assistant · Bayamon, PR

NPI 1760249643 · NPPES record last updated Mar 6, 2024

Key facts

NPI
1760249643
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
1495 (PR)
Practice address
B7 Calle Santa Cruz
Bayamon, PR 00961-6902
Phone
(787) 780-9196
NPI assigned
Mar 6, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1495PRMDPharmacy Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
363A00000X 1495 PR Yes

Addresses

Primary practice location

B7 Calle Santa Cruz
Bayamon, PR 00961-6902

Mailing address

HC 71 Box 16372
Bayamon, PR 00956-9849

Other providers in Bayamon, PR

All providers in Bayamon, PR · Physician Assistant in Puerto Rico

Sources for this page

Verify at the official NPI Registry.