Provider Demographics
NPI:1437409935
Name:BAYRON, FLAVIA ENID (PT)
Entity Type:Individual
Prefix:MRS
First Name:FLAVIA
Middle Name:ENID
Last Name:BAYRON
Suffix:
Gender:F
Credentials:PT
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 22514
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00931-2514
Mailing Address - Country:US
Mailing Address - Phone:178-753-6273
Mailing Address - Fax:
Practice Address - Street 1:110 CALLE DEL PARQUE
Practice Address - Street 2:BALMORAL COND. FIRST FLOOR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911-1901
Practice Address - Country:US
Practice Address - Phone:178-753-6273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR594174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist