MEDICARE: KR BYJU 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	207RG0100X	Gastroenterology Physician	ME83308	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME83308	OTHER		ME NUMBER
2	13743	OTHER	FL	BCBS
3	2206358	OTHER		UHC
4	1339812001	OTHER		CIGNA
5	01547	OTHER		UNIVERSAL
6	2744403	OTHER	FL	AETNA

General Provider Information

NPI Number	:	1649267972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KR BYJU MD

Provider Business Mailing Address
First Line	:	2401 UNIVERSITY PKWY
Second Line	:	STE 202
City	:	SARASOTA
State	:	FL
Zip	:	34243-2893
Country	:	US
Telephone Number	:	941-360-2579
Fax Number	:	941-360-2580

Provider Business Practice Location Address
First Line	:	2401 UNIVERSITY PKWY
Second Line	:	STE 202
City	:	SARASOTA
State	:	FL
Zip	:	34243
Country	:	US
Telephone Number	:	941-360-2579
Fax Number	:	941-360-2580

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

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	03/07/2023

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Directions to “ KR BYJU MD” Practice Location

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