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NPI Code Detail

MEDICARE: DR. JOSE ANTONIO BREA MD

MEDICARE:  DR. JOSE ANTONIO BREA  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
1207Q00000XFamily Medicine PhysicianME 111927FL

General Provider Information

NPI Number : 1336475417
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSE ANTONIO BREA MD
Provider Business Mailing Address
First Line : 8825 NW 189TH TER
Second Line :
City : HIALEAH
State : FL
Zip : 33018-6235
Country : US
Telephone Number : 786-376-2156
Fax Number : 305-884-3989
Provider Business Practice Location Address
First Line : 8399 PINES BLVD
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33024-6607
Country : US
Telephone Number : 954-518-6540
Fax Number : 954-443-8035
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2009
Last Update Date : 03/03/2017

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Directions to “ DR. JOSE ANTONIO BREA MD” Practice Location

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