MEDICARE: JANEAN BYRNE MS

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	101YM0800X	Mental Health Counselor	IMH13984	FL

General Provider Information

NPI Number	:	1356852990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANEAN BYRNE MS

Provider Business Mailing Address
First Line	:	2305 SE 8TH TER
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-7700
Country	:	US
Telephone Number	:	239-603-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	8359 BEACON BLVD STE 310
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-3062
Country	:	US
Telephone Number	:	239-603-1100
Fax Number	:	239-603-1100

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

Provider Enumeration Date	:	10/23/2017
Last Update Date	:	10/23/2017

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