Provider Demographics
NPI:1326146457
Name:BAYON, AWILDA (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:AWILDA
Middle Name:
Last Name:BAYON
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CALLE PEDRO ALBIZU CAMPOS
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-2434
Mailing Address - Country:US
Mailing Address - Phone:787-897-2050
Mailing Address - Fax:787-897-2778
Practice Address - Street 1:10 CALLE PEDRO ALBIZU CAMPOS
Practice Address - Street 2:
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669-2434
Practice Address - Country:US
Practice Address - Phone:787-897-2050
Practice Address - Fax:787-897-2778
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1809183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1809OtherPHARMACIST