Provider Demographics
NPI:1619930344
Name:BREIT, PAULA (MD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:BREIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 JIM MORAN BLVD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1701
Mailing Address - Country:US
Mailing Address - Phone:954-429-2418
Mailing Address - Fax:
Practice Address - Street 1:111 JIM MORAN BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1701
Practice Address - Country:US
Practice Address - Phone:954-429-2418
Practice Address - Fax:954-429-2389
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA89630207Q00000X
NC200601665207Q00000X
AL36813207Q00000X
MO2021042681207R00000X
FLME103201207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001432038Medicaid
CT001432038Medicaid
CT080001787Medicare ID - Type Unspecified