Individual provider Active NPI

Aila Elizabeth Rawlins, PA-C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1033667977
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109830 Issued in FL
Practice address
4761 S Cleveland Ave
Suite 3
Fort Myers, FL 33907-1375
Phone
(239) 343-9722
Fax
(239) 343-9725
NPI assigned
Sep 21, 2016
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109830 FL Primary

Addresses

Primary practice location

4761 S Cleveland Ave
Suite 3
Fort Myers, FL 33907-1375

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9722

Other identifiers 1

IdentifierTypeStateIssuer
018886700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161112000096 FL Practitioner - Physician Assistant 8921387010 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109830FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince May 1, 2019 Accepting new patients

Locations

16131 Roserush Ct
Fort Myers, FL 33908
Phone (239) 343-7300

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1033667977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9722",
            "fax_number": "239-343-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4761 S CLEVELAND AVE",
            "address_2": "SUITE 3",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071375",
            "telephone_number": "239-343-9722",
            "fax_number": "239-343-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWLINS",
        "first_name": "AILA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018886700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.