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General NPI Number Information
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NPI Number | 1821327412
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Entity Type | Individual
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Provider Name | WILLIAM BRAESKE DREYER JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/10/2009
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Last Update Date | 02/02/2010
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Provider Practice Location Address
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Address Line | 1715 SE TIFFANY AVE
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952-7520
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Country | US
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Telephone | 772-337-2020
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Fax | 772-337-1704
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Provider Business Mailing Address
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Address Line | 2101 SW RACQUET CLUB DR
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City | PALM CITY
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State | FL
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Zip | 34990-2303
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Country | US
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Telephone | 772-286-6880
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Fax | 772-382-6284
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME 35786
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License Number State | FL
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