Provider Demographics
NPI:1861500498
Name:BROZYNA, GERALD ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:ANTHONY
Last Name:BROZYNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9632 HALYARD DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773
Mailing Address - Country:US
Mailing Address - Phone:727-393-6880
Mailing Address - Fax:
Practice Address - Street 1:BAY PINES BLVD
Practice Address - Street 2:THE BAY PINES VA HEALTH CARE SYSTEM
Practice Address - City:BAY PINES
Practice Address - State:FL
Practice Address - Zip Code:33744
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:727-398-9412
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME29206207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine