Organization
JUAN C BAYOLO MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN CARLOS BAYOLO MD (PROPIETARY)
(813) 605-0662
Entity
Organization
Contact information
Practice address
3430 W LAMBRIGHT ST, SUITE 101, TAMPA, FL 33614-4750
(813) 605-0662
(813) 605-0663
Mailing address
3430 W LAMBRIGHT ST, SUITE 101, TAMPA, FL 33614-4750
(813) 605-0662
(813) 605-0663
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ACN247
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801848478
NPI
FL
05
—
278268500
—
FL
Enumeration date
07/13/2012
Last updated
09/15/2015
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