Provider Demographics
NPI:1467144139
Name:TORRES AYALA, JOMAR (LDO, ABOC, NCLEP)
Entity Type:Individual
Prefix:MR
First Name:JOMAR
Middle Name:
Last Name:TORRES AYALA
Suffix:
Gender:M
Credentials:LDO, ABOC, NCLEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8990 TURKEY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7320
Mailing Address - Country:US
Mailing Address - Phone:407-351-2994
Mailing Address - Fax:407-351-2062
Practice Address - Street 1:8990 TURKEY LAKE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7320
Practice Address - Country:US
Practice Address - Phone:407-351-2994
Practice Address - Fax:407-351-2062
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO7833156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDO7833OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH