Provider Demographics
NPI:1457587420
Name:BAYONA, CARLOS A (ARNP)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:A
Last Name:BAYONA
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3335
Mailing Address - Country:US
Mailing Address - Phone:407-788-8200
Mailing Address - Fax:407-788-3746
Practice Address - Street 1:360 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3335
Practice Address - Country:US
Practice Address - Phone:407-788-8200
Practice Address - Fax:407-788-3746
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9244308363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000907400Medicaid
FLCB223YMedicare PIN
FL000907400Medicaid