MEDICARE: AYA PAULEY PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA9102037	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477502888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYA PAULEY PA-C

Provider Business Mailing Address
First Line	:	2877 WELLNESS AVE
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8396
Country	:	US
Telephone Number	:	386-668-4650
Fax Number	:	386-668-4649

Provider Business Practice Location Address
First Line	:	2877 WELLNESS AVE
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8396
Country	:	US
Telephone Number	:	386-668-4650
Fax Number	:	386-668-4649

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	06/16/2016

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Directions to “ AYA PAULEY PA-C” Practice Location

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