Provider Demographics
NPI:1134796691
Name:LAYTON, GEORGE MANUEL (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:MANUEL
Last Name:LAYTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GEORGE
Other - Middle Name:MANUEL
Other - Last Name:LAYTON VELA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3513 PAVILION PALMS CIR APT 5-405
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-9024
Mailing Address - Country:US
Mailing Address - Phone:210-837-6460
Mailing Address - Fax:
Practice Address - Street 1:7345 JACKSON SPRINGS RD STE C-2
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-4754
Practice Address - Country:US
Practice Address - Phone:813-549-2940
Practice Address - Fax:813-549-2952
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1345208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice