Idalis Joan Medina Ayala

Primary specialty

PsychologistTaxonomy code 103T00000X

License

8452 Issued in PR

Practice address

Centro Comercial de San German 183
Avenida Universidad Interamericana Local 107
San German, PR 00683

Phone

(787) 661-5195

NPI assigned

Oct 29, 2025

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1962370940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CENTRO COMERCIAL DE SAN GERMAN 183",
            "address_2": "AVENIDA UNIVERSIDAD INTERAMERICANA LOCAL 107",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "00683",
            "telephone_number": "787-661-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTRO COMERCIAL DE SAN GERMAN 183",
            "address_2": "AVENIDA UNIVERSIDAD INTERAMERICANA LOCAL 107",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "00683",
            "telephone_number": "787-661-5195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA AYALA",
        "first_name": "IDALIS",
        "middle_name": "JOAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "8452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Med Heart Medical Equipment Corp
• Med Heart Medical Equipment Inc
• Ramon Medero-Roldan, M.D.
• Medicina Interna Ambulatoria Y Hospitalaria
• Medicina Interna LMG, CSP
• Enrique Medina, M.D.
• Ingrid Mendez - Altieri, PSY.D.
• Gabriela Mendez Flores, MSW
• Jose Rafael Mendez Lopez, MD
• Linda Nabell Mendez, MD

• Psychologist in San German, PR
• Providers in San German, PR by specialty
• Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.