MEDICARE: DR. THOMAS STEPHEN BREZA JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	ME98101	FL
2	207ND0101X	MOHS-Micrographic Surgery Physician	ME98101	FL

General Provider Information

NPI Number	:	1134298011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS STEPHEN BREZA JR. MD

Provider Business Mailing Address
First Line	:	4341 BOUGAINVILLA DR
Second Line	:
City	:	LAUDERDALE BY THE SEA
State	:	FL
Zip	:	33308-5017
Country	:	US
Telephone Number	:	954-492-8866
Fax Number	:	954-337-8180

Provider Business Practice Location Address
First Line	:	4341 BOUGAINVILLA DR
Second Line	:
City	:	LAUDERDALE BY THE SEA
State	:	FL
Zip	:	33308-5017
Country	:	US
Telephone Number	:	954-492-8866
Fax Number	:	954-337-8180

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	09/27/2010

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