Provider Demographics
NPI:1740096197
Name:AYALA, MELADY ELIZABETH (APRN)
Entity type:Individual
Prefix:
First Name:MELADY
Middle Name:ELIZABETH
Last Name:AYALA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MELADY
Other - Middle Name:ELIZABETH
Other - Last Name:ROMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6732 POMANDER AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-1922
Mailing Address - Country:US
Mailing Address - Phone:727-967-9100
Mailing Address - Fax:
Practice Address - Street 1:5824 STATE ROAD 54 STE 101
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-6061
Practice Address - Country:US
Practice Address - Phone:727-845-1933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11036719363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner