Provider Demographics
NPI:1417677550
Name:REDONDO, BAYOLET (APRN)
Entity Type:Individual
Prefix:
First Name:BAYOLET
Middle Name:
Last Name:REDONDO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10716 NW 87TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4610
Mailing Address - Country:US
Mailing Address - Phone:786-280-9032
Mailing Address - Fax:
Practice Address - Street 1:2600 SW 3RD AVE STE 600
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-2338
Practice Address - Country:US
Practice Address - Phone:786-280-9032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9421401163W00000X
FLAPRN11020875363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse