Provider Demographics
NPI:1316654957
Name:AYALA, DAYANA ALEJANDRA
Entity type:Individual
Prefix:
First Name:DAYANA
Middle Name:ALEJANDRA
Last Name:AYALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11777 SW 18TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-1626
Mailing Address - Country:US
Mailing Address - Phone:954-299-2216
Mailing Address - Fax:
Practice Address - Street 1:11777 SW 18TH ST APT 6
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-1626
Practice Address - Country:US
Practice Address - Phone:954-299-2216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19178224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19178OtherTHERAPY LICENSE