Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | ME131576 | FL |
NPI | 1134531155 |
---|---|
Provider Name | Karla Elena Diaz Ayllon |
First Address | Gainesville, FL 32610-0296 |
Second Address | Orange Park, FL 32073-5148 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2014 |
Last Update Date | 15/01/2022 |