MEDICARE: JOHN F BYRNES JR. PA C

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	363AS0400X	Surgical Physician Assistant	PA1679	FL
2	363A00000X	Physician Assistant	PA1679	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HF826A	OTHER	FL	MEDICARE GROUP PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1639163629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN F BYRNES JR. PA C

Provider Business Mailing Address
First Line	:	2100 OCOEE APOPKA RD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-9210
Country	:	US
Telephone Number	:	407-609-0095
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 OCOEE APOPKA RD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-9210
Country	:	US
Telephone Number	:	407-609-0095
Fax Number	:

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

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	06/10/2024

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