Provider Demographics
NPI:1629120373
Name:BUZA, PAUL W (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:W
Last Name:BUZA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:P.O. BOX 2227
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32902
Mailing Address - Country:US
Mailing Address - Phone:321-676-3200
Mailing Address - Fax:321-327-2893
Practice Address - Street 1:1698 W. HIBISCUS BLVD.
Practice Address - Street 2:BREVARD REGIONAL HYPERBARIC CENTER
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901
Practice Address - Country:US
Practice Address - Phone:321-676-3200
Practice Address - Fax:321-327-2893
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS63042084A0401X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL375123600Medicaid
FL80903OtherBLUE CROSS BLUE SHIELD FL
FL161619180001OtherTRICARE
FLF84914Medicare UPIN
FL375123600Medicaid