Provider Demographics
NPI:1962622134
Name:JAWAN AYER MD, LLC
Entity type:Organization
Organization Name:JAWAN AYER MD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAWAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:AYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-910-8700
Mailing Address - Street 1:5470 EAST BUSCH BLVD PMB 405
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617
Mailing Address - Country:US
Mailing Address - Phone:813-910-8700
Mailing Address - Fax:
Practice Address - Street 1:800 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:STE4
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-3320
Practice Address - Country:US
Practice Address - Phone:813-910-8700
Practice Address - Fax:813-978-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Multi-Specialty
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Multi-Specialty
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Multi-Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy