Provider Demographics
NPI:1063208585
Name:ALLAZ, BAYAN O (OD)
Entity type:Individual
Prefix:DR
First Name:BAYAN
Middle Name:O
Last Name:ALLAZ
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 1ST ST N STE 100
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4507
Mailing Address - Country:US
Mailing Address - Phone:863-299-8908
Mailing Address - Fax:
Practice Address - Street 1:215 1ST ST N STE 100
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4507
Practice Address - Country:US
Practice Address - Phone:863-299-8908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program