Individual
DR. ERNESTO AYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2150
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME91213
FL
207RH0000X
Hematology (Internal Medicine) Physician
Primary
ME91213
FL
207RH0003X
Hematology & Oncology Physician
ME91213
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270719500
—
FL
01
—
50006
BLUE CROSS BLUE SHIELD
FL
01
—
50006X
MEDICARE PTAN
FL
Enumeration date
07/12/2006
Last updated
08/31/2020
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