Provider Demographics
NPI:1588359194
Name:AYSON, EMMA VICTORIA A (APRN, FNP-C, AAHIV-M)
Entity type:Individual
Prefix:
First Name:EMMA VICTORIA
Middle Name:A
Last Name:AYSON
Suffix:
Gender:F
Credentials:APRN, FNP-C, AAHIV-M
Other - Prefix:
Other - First Name:FREDERICK
Other - Middle Name:A
Other - Last Name:AYSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP-C, AAHIV-M
Mailing Address - Street 1:1724 33RD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-8858
Mailing Address - Country:US
Mailing Address - Phone:407-553-6336
Mailing Address - Fax:321-445-9733
Practice Address - Street 1:1724 33RD ST STE 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-8858
Practice Address - Country:US
Practice Address - Phone:407-553-6336
Practice Address - Fax:321-445-9733
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016325207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine