Jose L Ayala Jr.
Individual provider Active NPI Physical Therapy Assistant · Lake City, FL
NPI 1669009304 · NPPES record last updated Mar 24, 2020
Key facts
- NPI
- 1669009304
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 123128 (FL)
- Practice address
- 560 SW McFarlane Ave
Lake City, FL 32025-5614 - Phone
- (386) 758-4777
- NPI assigned
- Mar 24, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123128 | FL | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 123128 | FL | Yes |
Addresses
Primary practice location
560 SW McFarlane Ave
Lake City, FL 32025-5614
Mailing address
159 SW Clewiston CT # B
Fort White, FL 32038-4557
Phone (352) 398-2695
Other providers in Lake City, FL
- Cynthia Austin Mobley
- James M Autry
- Aloralee D Avery
- Stephanie A Avery
- William Mark Avonda
- B & L Transit
- B & L Transit 2
- Akeidria Bailey
- Emily Bailey
- Hillary Bailey
All providers in Lake City, FL · Physical Therapy Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.