Provider Demographics
NPI:1174660476
Name:BAYKO, BARBARA A (PA-C)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:BAYKO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746638
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6638
Mailing Address - Country:US
Mailing Address - Phone:904-202-1032
Mailing Address - Fax:904-376-4107
Practice Address - Street 1:45465 5TH AVE.
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:30374
Practice Address - Country:US
Practice Address - Phone:904-879-4544
Practice Address - Fax:904-390-7472
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9102356363AM0700X
FLPA9102356363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01006238OtherRR MEDICARE
FLBF233YMedicare PIN
FLS51849Medicare UPIN
FLPAX00005204OtherPRESCRIPTION PROVIDER #
FLS51849Medicare UPIN