Provider Demographics
NPI:1932104015
Name:BAYRON, JUAN JOSE (MD)
Entity Type:Individual
Prefix:MR
First Name:JUAN JOSE
Middle Name:
Last Name:BAYRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1791 CALLE ESTEBAN PADILLA
Mailing Address - Street 2:URBANIZACION SANTIAGO IGLESIAS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-4237
Mailing Address - Country:US
Mailing Address - Phone:787-783-0399
Mailing Address - Fax:787-793-3965
Practice Address - Street 1:1791 CALLE ESTEBAN PADILLA
Practice Address - Street 2:URBANIZACION SANTIAGO IGLESIAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-4237
Practice Address - Country:US
Practice Address - Phone:787-783-0399
Practice Address - Fax:787-793-3965
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11759174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR87640Medicare ID - Type Unspecified
PRG41098Medicare UPIN