Provider Demographics
NPI:1134298011
Name:BREZA, THOMAS STEPHEN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:STEPHEN
Last Name:BREZA
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:4341 BOUGAINVILLA DR
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE BY THE SEA
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5017
Mailing Address - Country:US
Mailing Address - Phone:954-492-8866
Mailing Address - Fax:954-337-8180
Practice Address - Street 1:4341 BOUGAINVILLA DR
Practice Address - Street 2:
Practice Address - City:LAUDERDALE BY THE SEA
Practice Address - State:FL
Practice Address - Zip Code:33308-5017
Practice Address - Country:US
Practice Address - Phone:954-492-8866
Practice Address - Fax:954-337-8180
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2010-09-27
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Provider Licenses
StateLicense IDTaxonomies
FLME98101207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCB294YMedicare PIN