Provider Demographics
NPI:1265418743
Name:BIEZUNSKI, DAVID ROBERT (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ROBERT
Last Name:BIEZUNSKI
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:ROBERT
Other - Last Name:BIEZUNSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3745 11TH CIR STE 103
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4838
Mailing Address - Country:US
Mailing Address - Phone:772-589-0580
Mailing Address - Fax:
Practice Address - Street 1:3745 11TH CIR
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4837
Practice Address - Country:US
Practice Address - Phone:772-589-0580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME44223207RE0101X
FLME62133207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370668100Medicaid
FLF39298Medicare UPIN