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General NPI Number Information
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NPI Number | 1659600120
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Entity Type | Organization
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Legal Business Name | THOMAS STEPHEN BREZA JR MD PA
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Dates
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Enumeration Date | 12/13/2009
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Last Update Date | 09/27/2010
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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 | 954-492-8866
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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 | 954-492-8866
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Fax | 954-337-8180
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS STEPHEN BREZA JR.
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Credential | MD
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Telephone | 352-275-2554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME98101
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License Number State | FL
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