Provider Demographics
NPI:1841467883
Name:BUYO, GLENDA Y (MD)
Entity type:Individual
Prefix:DR
First Name:GLENDA
Middle Name:Y
Last Name:BUYO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 PLANTATION LLC
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322
Mailing Address - Country:US
Mailing Address - Phone:954-474-0110
Mailing Address - Fax:954-424-9859
Practice Address - Street 1:1806 PLANTATION LLC
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322
Practice Address - Country:US
Practice Address - Phone:954-474-0110
Practice Address - Fax:954-424-9859
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME125015207Q00000X
PAMD-435548207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102276923Medicaid
PA147355ZFD2Medicare PIN