Provider Demographics
NPI:1154388759
Name:BYRNE, THOMAS EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:EDWARD
Last Name:BYRNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3356 CANOE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-6536
Mailing Address - Country:US
Mailing Address - Phone:407-891-2992
Mailing Address - Fax:407-891-2993
Practice Address - Street 1:3356 CANOE CREEK RD
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34772-6536
Practice Address - Country:US
Practice Address - Phone:407-891-2992
Practice Address - Fax:407-891-2993
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME146890207Q00000X
WAMD00049360207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8883441Medicare PIN
WAG8883442Medicare PIN