Individual
LYLE G BREEDING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11373 CORTEZ BLVD, SUITE 202, BROOKSVILLE, FL 34613-5414
(352) 597-3444
(352) 597-0117
Mailing address
11373 CORTEZ BLVD, SUITE 202, BROOKSVILLE, FL 34613-5414
(352) 597-3444
(352) 597-0117
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R9N91
MO
2086S0129X
Vascular Surgery Physician
R9N91
MO
261QM2500X
Medical Specialty Clinic/Center
ME102374
FL
Other
Enumeration date
05/07/2007
Last updated
02/14/2018
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