Individual
DR. JUAN C BAYOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
309 W 1ST ST, SANFORD, FL 32771-1205
(407) 324-5035
Mailing address
3131 EGRETS LANDING DR, LAKE MARY, FL 32746-7419
(787) 587-6195
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
15486
PR
208D00000X
General Practice Physician
4301113879
MI
208D00000X
General Practice Physician
Primary
ACN247
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101229200
—
FL
01
—
HQ793Z
MEDICARE ID
—
Enumeration date
05/16/2006
Last updated
10/02/2024
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