Healthcare Provider Details

I. General information

NPI: 1609599422
Provider Name (Legal Business Name): JESSICA LINETTE GARCIA BAYON OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 PABELLON DE PUERTO RICO
TOA BAJA PR
00949-2246
US

IV. Provider business mailing address

254 PABELLON DE PUERTO RICO
TOA BAJA PR
00949-2246
US

V. Phone/Fax

Practice location:
  • Phone: 787-942-5488
  • Fax:
Mailing address:
  • Phone: 787-942-5488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number760
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: