Healthcare Provider Details

I. General information

NPI: 1285820803
Provider Name (Legal Business Name): FERNANDO E. BAYRON, MD, PA.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NW 82ND AVE SUITE 405
PLANTATION FL
33324-7808
US

IV. Provider business mailing address

201 NW 82ND AVENUE SUITE 405
PLANTATION FL
33076
US

V. Phone/Fax

Practice location:
  • Phone: 954-472-1322
  • Fax: 954-370-3420
Mailing address:
  • Phone: 954-472-1322
  • Fax: 954-370-3420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME93401
License Number StateFL

VIII. Authorized Official

Name: DR. FERNANDO E BAYRON
Title or Position: PRESIDENT
Credential: MD
Phone: 954-472-1322