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General NPI Number Information
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NPI Number | 1114259165
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Entity Type | Organization
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Legal Business Name | THOMAS S BREZA MD PA
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Dates
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Enumeration Date | 02/02/2010
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Last Update Date | 02/02/2010
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Provider Practice Location Address
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Address Line | 4341 BOUGAINVILLA DR
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City | LAUDERDALE BY THE SEA
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State | FL
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Zip | 33308-5017
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Country | US
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Telephone | 954-792-8866
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Fax | 954-337-8180
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Provider Business Mailing Address
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Address Line | 4341 BOUGAINVILLA DR
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City | LAUDERDALE BY THE SEA
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State | FL
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Zip | 33308-5017
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Country | US
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Telephone | 954-792-8866
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Fax | 954-337-8180
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. CAROLYN JULIA BREZA
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Credential |
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Telephone | 954-492-8866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0022052
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License Number State | FL
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