Provider Demographics
NPI:1881624609
Name:AYES, IRWIN IRA (DPM)
Entity type:Individual
Prefix:DR
First Name:IRWIN
Middle Name:IRA
Last Name:AYES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12001 94TH ST
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-4304
Mailing Address - Country:US
Mailing Address - Phone:727-393-8269
Mailing Address - Fax:888-361-9623
Practice Address - Street 1:12001 94TH ST
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-4304
Practice Address - Country:US
Practice Address - Phone:727-393-8269
Practice Address - Fax:888-361-9623
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0000915213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0485340001OtherDMERC
FLT55429Medicare UPIN
FL0485340001OtherDMERC