Provider Demographics
NPI:1053487454
Name:LAYTON, STEVEN E (PA - C)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:E
Last Name:LAYTON
Suffix:
Gender:M
Credentials:PA - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5604 GLENCREST BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-1001
Mailing Address - Country:US
Mailing Address - Phone:813-802-9969
Mailing Address - Fax:813-354-4797
Practice Address - Street 1:2919 W SWANN AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4038
Practice Address - Country:US
Practice Address - Phone:813-874-9115
Practice Address - Fax:813-876-2489
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9100648363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE6343Medicare ID - Type Unspecified
FLP41434Medicare UPIN