Provider Demographics
NPI:1164302253
Name:BAYRON, MARIA FERNANDA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:FERNANDA
Last Name:BAYRON
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:FERNANDA
Other - Last Name:BAYRON VAZQUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5560 NW 61ST ST APT 706
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-2525
Mailing Address - Country:US
Mailing Address - Phone:954-698-9222
Mailing Address - Fax:787-585-6727
Practice Address - Street 1:7700 RENFREW LN
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-3508
Practice Address - Country:US
Practice Address - Phone:787-585-6727
Practice Address - Fax:787-585-6727
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program