Provider Demographics
NPI:1376653535
Name:JOHN C. AYALA, M.D., P.A.
Entity Type:Organization
Organization Name:JOHN C. AYALA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-598-5232
Mailing Address - Street 1:7000 SW 97TH AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1494
Mailing Address - Country:US
Mailing Address - Phone:305-598-5232
Mailing Address - Fax:305-598-5236
Practice Address - Street 1:7000 SW 97TH AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1494
Practice Address - Country:US
Practice Address - Phone:305-598-5232
Practice Address - Fax:305-598-5236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79087174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257331800Medicaid
FLH05032Medicare UPIN
FL49205XMedicare PIN