Provider Demographics
NPI:1952545857
Name:DE AZA, AKILAH N (MD)
Entity Type:Individual
Prefix:
First Name:AKILAH
Middle Name:N
Last Name:DE AZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AKILAH
Other - Middle Name:N
Other - Last Name:EVERING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1340 TUSKAWILLA RD STE 101-5
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5030
Mailing Address - Country:US
Mailing Address - Phone:407-699-1160
Mailing Address - Fax:
Practice Address - Street 1:1340 TUSKAWILLA RD STE 101-5
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5030
Practice Address - Country:US
Practice Address - Phone:407-699-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108512207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine