Provider Demographics
NPI:1033667977
Name:RAWLINS, AILA ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:AILA
Middle Name:ELIZABETH
Last Name:RAWLINS
Suffix:
Gender:F
Credentials:PA-C
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 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-9722
Mailing Address - Fax:239-343-9725
Practice Address - Street 1:4761 S CLEVELAND AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1375
Practice Address - Country:US
Practice Address - Phone:239-343-9722
Practice Address - Fax:239-343-9725
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9109830363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018886700Medicaid