Provider Demographics
NPI:1982488912
Name:AYALA SILVA, SOFIA MARIA (OTR/L)
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:MARIA
Last Name:AYALA SILVA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BB24 CALLE CASTILLA
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-1904
Mailing Address - Country:US
Mailing Address - Phone:787-247-0302
Mailing Address - Fax:
Practice Address - Street 1:1260 CALLE 54 SE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3143
Practice Address - Country:US
Practice Address - Phone:787-999-5538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1361225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist