Provider Demographics
NPI:1780895722
Name:LIVINGSTONE, AYISHA ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:AYISHA
Middle Name:ELIZABETH
Last Name:LIVINGSTONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 NE 20TH TER STE 303
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4510
Mailing Address - Country:US
Mailing Address - Phone:954-771-8177
Mailing Address - Fax:954-771-3629
Practice Address - Street 1:4800 NE 20TH TER STE 303
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4510
Practice Address - Country:US
Practice Address - Phone:954-771-8177
Practice Address - Fax:954-771-3629
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 103967207X00000X
FLME103967207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8114600Medicaid
FLDL543ZMedicare PIN