Provider Demographics
NPI:1497943591
Name:AYA-AY, MELANIE L (MD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:L
Last Name:AYA-AY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:16626 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618
Mailing Address - Country:US
Mailing Address - Phone:813-774-5733
Mailing Address - Fax:813-774-5619
Practice Address - Street 1:16626 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618
Practice Address - Country:US
Practice Address - Phone:813-774-5733
Practice Address - Fax:813-774-5619
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME103677208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDH469ZMedicare PIN