1063533016 NPI number — STUART BYER M.D. PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063533016 NPI number — STUART BYER M.D. PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STUART BYER M.D. PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063533016
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2121 E CRAWFORD PL
Provider Second Line Business Mailing Address:
PO BOX 256
Provider Business Mailing Address City Name:
SALINA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67401-3719
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-823-0633
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 36TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VERO BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32960-4862
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
772-567-4311
Provider Business Practice Location Address Fax Number:
772-569-6949
Provider Enumeration Date:
04/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BYER
Authorized Official First Name:
STUART
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
RADIATION ONCOLOGIST
Authorized Official Telephone Number:
772-567-4311

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  ME0044416 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 64521 . This is a "BCBS OF FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5121669 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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