MEDICARE: THOMAS STEPHEN BREZA JR MD PA

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	207N00000X	Dermatology Physician	ME98101	FL

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	:	1659600120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS STEPHEN BREZA JR MD PA

Provider Business Mailing Address
First Line	:	4341 BOUGAINVILLA DR
Second Line	:
City	:	LAUDERDALE BY THE SEA
State	:	FL
Zip	:	33308-5017
Country	:	US
Telephone Number	:	954-492-8866
Fax Number	:	954-337-8180

Provider Business Practice Location Address
First Line	:	4341 BOUGAINVILLA DR
Second Line	:
City	:	LAUDERDALE BY THE SEA
State	:	FL
Zip	:	33308-5017
Country	:	US
Telephone Number	:	954-492-8866
Fax Number	:	954-337-8180

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS STEPHEN BREZA JR.
Credential	:	MD
Telephone Number	:	352-275-2554

Provider Enumeration Date	:	12/13/2009
Last Update Date	:	09/27/2010

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