MEDICARE: DR. THOMAS EDWARD BYRNE M.D.

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	207Q00000X	Family Medicine Physician	ME146890	FL
2	207Q00000X	Family Medicine Physician	MD00049360	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154388759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS EDWARD BYRNE M.D.

Provider Business Mailing Address
First Line	:	3356 CANOE CREEK RD
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34772-6536
Country	:	US
Telephone Number	:	407-891-2992
Fax Number	:	407-891-2993

Provider Business Practice Location Address
First Line	:	3356 CANOE CREEK RD
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34772-6536
Country	:	US
Telephone Number	:	407-891-2992
Fax Number	:	407-891-2993

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	12/17/2024

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