MEDICARE: GUILLERMO AYALA

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	343900000X	Non-emergency Medical Transport (VAN)	A400280684090	FL

General Provider Information

NPI Number	:	1194685511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUILLERMO AYALA

Provider Business Mailing Address
First Line	:	4220 LAVENDER CT
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-9793
Country	:	US
Telephone Number	:	347-784-0893
Fax Number	:

Provider Business Practice Location Address
First Line	:	4220 LAVENDER CT
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-9793
Country	:	US
Telephone Number	:	347-784-0893
Fax Number	:

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

Provider Enumeration Date	:	11/17/2025
Last Update Date	:	11/17/2025

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Directions to “ GUILLERMO AYALA ” Practice Location

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