# DR. JUAN C BAYOLO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1801848478
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 15486 | PR | — |
| 208D00000X | General Practice Physician | 4301113879 | MI | — |
| 208D00000X | General Practice Physician | ACN247 | FL | Yes |

## Other

- **Enumeration date:** 05/16/2006
- **Last updated:** 10/02/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 101229200 | — | FL |
| 01 | — | HQ793Z | MEDICARE ID | — |