Basic Information
| Provider Information | |||||||||
| NPI: | 1134298011 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BREZA | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | STEPHEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4341 BOUGAINVILLA DR | ||||||||
| Address2: | |||||||||
| City: | LAUDERDALE BY THE SEA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333085017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544928866 | ||||||||
| FaxNumber: | 9543378180 | ||||||||
| Practice Location | |||||||||
| Address1: | 4341 BOUGAINVILLA DR | ||||||||
| Address2: | |||||||||
| City: | LAUDERDALE BY THE SEA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333085017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544928866 | ||||||||
| FaxNumber: | 9543378180 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2006 | ||||||||
| LastUpdateDate: | 09/27/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | ME98101 | FL | N | Allopathic & Osteopathic Physicians | Dermatology | 207ND0101X | ME98101 | FL | Y | Allopathic & Osteopathic Physicians | Dermatology | MOHS-Micrographic Surgery |
No ID Information.