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General NPI Number Information
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NPI Number | 1437409935
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Entity Type | Individual
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Provider Name | FLAVIA ENID BAYRON PT
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Gender | Female
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 110 CALLE DEL PARQUE BALMORAL COND. FIRST FLOOR
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City | SAN JUAN
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State | PR
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Zip | 00911-1901
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Country | US
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Telephone | 178-753-6273
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22514
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City | SAN JUAN
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State | PR
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Zip | 00931-2514
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Country | US
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Telephone | 178-753-6273
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 594
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License Number State | PR
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