Provider Demographics
NPI:1649786781
Name:AYRAL, ERICA A (PA-C)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:A
Last Name:AYRAL
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:A
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 6TH AVE S STE 450
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4629
Mailing Address - Country:US
Mailing Address - Phone:727-898-2663
Mailing Address - Fax:
Practice Address - Street 1:625 6TH AVE S STE 450
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4629
Practice Address - Country:US
Practice Address - Phone:727-898-2663
Practice Address - Fax:727-568-6836
Is Sole Proprietor?:No
Enumeration Date:2017-12-27
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363A00000X
FLPA9110977363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0X6B5OtherFLORIDA BLUE
FL100782600Medicaid