MEDICARE: DR. DAVID CARTHAGE BYRNES JR. 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
1	207R00000X	Internal Medicine Physician	ME114343	FL
2	207RG0100X	Gastroenterology Physician	138791	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01151446	OTHER	FL	RR MEDICARE

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
3	ME114343	OTHER	FL	LICENSE NO
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699778019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID CARTHAGE BYRNES JR. MD

Provider Business Mailing Address
First Line	:	PO BOX 20065
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33622-0065
Country	:	US
Telephone Number	:	813-890-8004
Fax Number	:	813-290-9691

Provider Business Practice Location Address
First Line	:	2810 W SAINT ISABEL ST
Second Line	:	SUITE 201
City	:	TAMPA
State	:	FL
Zip	:	33607-6375
Country	:	US
Telephone Number	:	813-890-8004
Fax Number	:	813-290-9691

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	11/03/2015

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Directions to “ DR. DAVID CARTHAGE BYRNES JR. MD” Practice Location

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