Provider Demographics
NPI:1396756086
Name:QUIJANO AYALA, ISABEL (MD)
Entity type:Individual
Prefix:DR
First Name:ISABEL
Middle Name:
Last Name:QUIJANO AYALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1786
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-1786
Mailing Address - Country:US
Mailing Address - Phone:787-269-0988
Mailing Address - Fax:787-995-6925
Practice Address - Street 1:AVENIDA LAUREL
Practice Address - Street 2:ESQUINA SANTA JUANITA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960
Practice Address - Country:US
Practice Address - Phone:787-269-0988
Practice Address - Fax:787-995-6925
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5425207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0080002Medicare ID - Type Unspecified
C77758Medicare UPIN