Healthcare Provider Details

I. General information

NPI: 1841273943
Provider Name (Legal Business Name): JAWAN CORINE AYER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W DR MARTIN LUTHER KING JR BLVD STE 4
TAMPA FL
33603-3320
US

IV. Provider business mailing address

5470 E BUSCH BLVD PMB 405
TEMPLE TERRACE FL
33617-5418
US

V. Phone/Fax

Practice location:
  • Phone: 813-971-8700
  • Fax: 813-978-3070
Mailing address:
  • Phone: 813-971-6000
  • Fax: 813-978-3070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License NumberME90596
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License NumberME90596
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME90596
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME90596
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberME90596
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME90596
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: