Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | ME98101 | FL |
Y | 207ND0101X | MOHS-Micrographic Surgeon | ME98101 | FL |
NPI | 1134298011 |
---|---|
Provider Name | Dr. Thomas Stephen Breza JR. |
First Address | Lauderdale By The Sea, FL 33308-5017 |
Second Address | Lauderdale By The Sea, FL 33308-5017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 27/09/2010 |