| Juan C Bayolo Md Llc | |
|
3430 W Lambright St Suite 101 Tampa FL 33614-4750 | |
| (813) 605-0662 | |
| (813) 605-0663 |
| Full Name | Juan C Bayolo Md Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3430 W Lambright St, Tampa, Florida |
| Authorized Official Name and Position | Juan Carlos Bayolo (PROPIETARY) |
| Authorized Official Contact | 8136050662 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Juan C Bayolo Md Llc 3430 W Lambright St Suite 101 Tampa FL 33614-4750 Ph: (813) 605-0662 | Juan C Bayolo Md Llc 3430 W Lambright St Suite 101 Tampa FL 33614-4750 Ph: (813) 605-0662 |
| NPI Number | 1386999589 |
|---|---|
| Provider Enumeration Date | 07/13/2012 |
| Last Update Date | 09/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386999589 | NPI | - | NPPES |
| 278268500 | Medicaid | FL | |
| 1801848478 | Other | FL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ACN247 (Florida) | Primary |
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