Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | ME72379 | FL |
Y | 207RH0003X | Hematology & Oncology | ME72379 | FL |
N | 207RX0202X | Medical Oncology | ME72379 | FL |
NPI | 1194769810 |
---|---|
Provider Name | Dr. Sung Tae Byun |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Largo, FL 33777-1251 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 03/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
261657200 | (05) | FL |
830003154 | RAILROAD MEDICARE (01) | FL |
F60629 | (02) | FL |