Provider Demographics
NPI:1740580810
Name:BAYON, KRYSTAL MARIE (MS OT)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:MARIE
Last Name:BAYON
Suffix:
Gender:F
Credentials:MS OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 NATURES HAMMOCK RD N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32259-2880
Mailing Address - Country:US
Mailing Address - Phone:305-527-9326
Mailing Address - Fax:
Practice Address - Street 1:7504 SW 139TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-3044
Practice Address - Country:US
Practice Address - Phone:305-383-7262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-23
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14348225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist