Provider Demographics
NPI:1477546786
Name:BRYER, MARK ALEC (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALEC
Last Name:BRYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9090 SW 87TH CT
Mailing Address - Street 2:STE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2315
Mailing Address - Country:US
Mailing Address - Phone:305-596-2080
Mailing Address - Fax:305-596-0657
Practice Address - Street 1:9090 SW 87TH CT
Practice Address - Street 2:STE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2315
Practice Address - Country:US
Practice Address - Phone:305-596-2080
Practice Address - Fax:305-596-0657
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME972972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2292791Medicaid
OHBR40612061718Medicare ID - Type Unspecified
G84180Medicare UPIN
OHBR4095271Medicare ID - Type Unspecified