Provider Demographics
NPI:1407807928
Name:PAYLOR, RALPH R (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:R
Last Name:PAYLOR
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 1:502 E NEW HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-5427
Mailing Address - Country:US
Mailing Address - Phone:321-727-2020
Mailing Address - Fax:321-984-9547
Practice Address - Street 1:502 E NEW HAVEN AVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-5427
Practice Address - Country:US
Practice Address - Phone:321-727-2020
Practice Address - Fax:321-984-9547
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME48261207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2000387OtherAETNA HMO
FL05598OtherBLUE CROSS/BLUE SHIELD
FL180032670OtherRAILROAD MEDICARE
FL4038998OtherAETNA PPO
FL2714301003OtherCIGNA
FL706303OtherFIRST HEALTH
FL166528OtherCCN
FL043955000Medicaid
FL2714301003OtherCIGNA
FL043955000Medicaid