Provider Demographics
NPI:1205409687
Name:BAYRON AUBRET, EDLYN LORELL (MD)
Entity Type:Individual
Prefix:DR
First Name:EDLYN
Middle Name:LORELL
Last Name:BAYRON AUBRET
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:HC 10 BOX 7494
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-9673
Mailing Address - Country:US
Mailing Address - Phone:787-383-4315
Mailing Address - Fax:
Practice Address - Street 1:CARR 363 KM 0.9 INT 0.1 BO LA MAQUINA
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637
Practice Address - Country:US
Practice Address - Phone:787-383-4315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-22
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22396208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice