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Organization
KWABENA AYESU M D P A
Active
Organization
KWABENA AYESU M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KWABENA AYESU MD (DOCTOR/OWNER)
(386) 774-6111
Entity
Organization
Contact information
Practice address
86 SPRING VISTA DR, SUITE 100, DEBARY, FL 32713-1818
(386) 774-6111
(386) 774-8111
Mailing address
86 SPRING VISTA DR, SUITE 100, DEBARY, FL 32713-1818
(386) 774-6111
(386) 774-8111
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81108B
BCBS
FL
01
—
P00269607
RAILROAD MEDICARE
FL
Enumeration date
08/17/2007
Last updated
06/19/2008
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