Provider Demographics
NPI:1386888592
Name:AYAR, ANGELO EMMANUEL (MD)
Entity type:Individual
Prefix:
First Name:ANGELO
Middle Name:EMMANUEL
Last Name:AYAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 N UNIVERSITY DR STE 102
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2909
Mailing Address - Country:US
Mailing Address - Phone:954-726-2000
Mailing Address - Fax:954-726-2867
Practice Address - Street 1:7301 N UNIVERSITY DR STE 102
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321
Practice Address - Country:US
Practice Address - Phone:954-726-2000
Practice Address - Fax:954-726-3109
Is Sole Proprietor?:No
Enumeration Date:2009-05-01
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME123952207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIF421ZMedicare PIN