Provider Demographics
NPI:1972186765
Name:AYALA, LINDSEY ELIZABETH (DPT, PT, LAT, ATC)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:ELIZABETH
Last Name:AYALA
Suffix:
Gender:F
Credentials:DPT, PT, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5915 BRADEN RUN
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202-9403
Mailing Address - Country:US
Mailing Address - Phone:813-766-9683
Mailing Address - Fax:
Practice Address - Street 1:100 2ND AVE NE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3405
Practice Address - Country:US
Practice Address - Phone:727-502-1291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL300782251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports