Healthcare Provider Details

I. General information

NPI: 1962622134
Provider Name (Legal Business Name): JAWAN AYER MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 09/02/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W DR MARTIN LUTHER KING JR BLVD STE4
TAMPA FL
33603-3320
US

IV. Provider business mailing address

5470 EAST BUSCH BLVD PMB 405
TEMPLE TERRACE FL
33617
US

V. Phone/Fax

Practice location:
  • Phone: 813-910-8700
  • Fax: 813-978-3070
Mailing address:
  • Phone: 813-910-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JAWAN C AYER
Title or Position: OWNER
Credential: MD
Phone: 813-910-8700