Individual
DR. BYRON RENARD DEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1500 LAKELAND HILLS BLVD STE 4, LAKELAND, FL 33805
(863) 937-7157
(863) 333-0260
Mailing address
3616 HARDEN BLVD, #311, LAKELAND, FL 33803-5938
(863) 937-7157
(863) 333-0260
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0S9203
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00396100R
MEDICAID GROUP #
FL
01
—
16757
BLUE CROSS
—
05
—
245345600
—
FL
01
—
EY656A
MEDICARE GROUP PTAN
FL
Enumeration date
07/12/2006
Last updated
04/12/2023
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