Provider Demographics
NPI:1437798832
Name:PIERRE, AYANA (OD)
Entity Type:Individual
Prefix:
First Name:AYANA
Middle Name:
Last Name:PIERRE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8866 CONWAY RD
Mailing Address - Street 2:
Mailing Address - City:POLK CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33868-9020
Mailing Address - Country:US
Mailing Address - Phone:786-431-9026
Mailing Address - Fax:
Practice Address - Street 1:2600 POSNER BLVD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-3638
Practice Address - Country:US
Practice Address - Phone:863-623-3155
Practice Address - Fax:863-333-5667
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5747152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist