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General NPI Number Information
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NPI Number | 1629501218
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Entity Type | Individual
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Provider Name | AYANA WORTHEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2017
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 2 TAMPA GENERAL CIR
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City | TAMPA
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State | FL
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Zip | 33606-3571
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Country | US
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Telephone | 813-821-8038
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 E COLLEGE AVE
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City | BLOOMINGTON
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State | IL
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Zip | 61704-2100
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Country | US
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Telephone | 309-664-3000
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME163749
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036173252
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License Number State | IL
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