Organization Active NPI

Ivan L Ayala MD PA

  • Multi-Specialty Clinic/Center
  • Plantation, FL
National Provider Identifier
1972740462
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
IVAN L AYALA MD PA
Practice address
220 SW 84TH Ave Ste 106
Plantation, FL 33324-2729
Phone
(954) 452-0774
NPI assigned
Jan 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Authorized official

Name
Dr. Ivan Ayala, M.D.NPI 1497830897
Title
President
Phone
(954) 318-2090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

220 SW 84TH Ave Ste 106
Plantation, FL 33324-2729

Mailing address

220 SW 84TH Ave Ste 106
Plantation, FL 33324-2729
Phone (954) 452-0774

Other names 1

  • Atlantic Coast Radiology, SF Other name

National Provider Directory

National Provider Directory

Locations

10230 W State Road 84
Davie, FL 33324
Phone (954) 318-2090

3380 Fairlane Farms Rd
Ste 6
Wellington, FL 33414
Phone (561) 252-8364

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1972740462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 SW 84TH AVE STE 106",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242729",
            "telephone_number": "954-452-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SW 84TH AVE STE 106",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242729",
            "telephone_number": "954-452-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVAN L AYALA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-21",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "AYALA",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-318-2090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlantic Coast Radiology, SF",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Atlantic Coast Radiology, SF",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.