Provider Demographics
NPI:1093786634
Name:AYER, ORION THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:ORION
Middle Name:THOMAS
Last Name:AYER
Suffix:
Gender:M
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:P.O. DRAWER 16007
Mailing Address - Street 2:
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33733
Mailing Address - Country:US
Mailing Address - Phone:727-894-3937
Mailing Address - Fax:727-821-0771
Practice Address - Street 1:1955 1ST AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8941
Practice Address - Country:US
Practice Address - Phone:727-894-3937
Practice Address - Fax:727-821-0771
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34930207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL066489800Medicaid
FL066489800Medicaid
FLE46023Medicare UPIN