Individual provider · NPI-1

Dr. Agnes Elizabeth Aysola, M.D.

Pathology, Anatomic Pathology & Clinical Pathology · Jacksonville, FL

NPI number1689618811
StatusActive
Last updated in NPPESJun 10, 2009

Details

NPI
1689618811
Entity type
Individual (NPI-1)
Name
Dr. Agnes Elizabeth Aysola
Credential
M.D.
Sex
Female
Sole proprietor
No
Enumeration date
Jun 16, 2006
Last updated
Jun 10, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207ZP0102X Pathology, Anatomic Pathology & Clinical PathologyME103131FLYes
207ZB0001X Pathology, Blood Banking & Transfusion Medicine42392MN
207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology42392MN
207ZB0001X Pathology, Blood Banking & Transfusion MedicineME103131FL

Practice location

655 W 8th St
Ufjp Pathology Dept.
Jacksonville, FL 32209-6511

Phone 904-244-4387

Mailing address

Po Box 44008
Ufjp Provider Enrollment
Jacksonville, FL 32231-4008

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