Provider Demographics
NPI:1285820803
Name:FERNANDO E. BAYRON, MD, PA.
Entity Type:Organization
Organization Name:FERNANDO E. BAYRON, MD, PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:E
Authorized Official - Last Name:BAYRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-472-1322
Mailing Address - Street 1:201 NW 82ND AVENUE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33076
Mailing Address - Country:US
Mailing Address - Phone:954-472-1322
Mailing Address - Fax:954-370-3420
Practice Address - Street 1:201 NW 82ND AVE
Practice Address - Street 2:SUITE 405
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7808
Practice Address - Country:US
Practice Address - Phone:954-472-1322
Practice Address - Fax:954-370-3420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93401208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9549Medicare PIN