Provider Demographics
NPI:1982051348
Name:JAYO, JUAN (ARNP)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:
Last Name:JAYO
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 1:20941 BAY CT APT. 126
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3726
Mailing Address - Country:US
Mailing Address - Phone:786-877-0650
Mailing Address - Fax:
Practice Address - Street 1:1611 NW 12TH AVENUE
Practice Address - Street 2:CENTRAL BUILDING SUITE 600B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1096
Practice Address - Country:US
Practice Address - Phone:305-355-1303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9245009363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health