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General NPI Number Information
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NPI Number | 1104715275
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Entity Type | Individual
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Provider Name | EMERSON ALEXANDER AMAYA SA-C
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Gender | Male
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 1048 LEIGHTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90037-1612
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Country | US
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Telephone | 786-674-3177
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Fax |
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Provider Business Mailing Address
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Address Line | 1048 LEIGHTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90037-1612
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Country | US
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Telephone | 786-674-3177
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 25-321
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License Number State | FL
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