Individual
DR. SUNG TAE BYUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8787 BRYAN DAIRY RD, SUITE 210, LARGO, FL 33777-1251
(727) 397-9641
(727) 393-4194
Mailing address
4371 VERONICA S SHOEMAKER BLVD, ATTN CREDENTIALING, FORT MYERS, FL 33916-2216
(239) 274-8200
(239) 278-3350
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
ME72379
FL
207RH0003X
Hematology & Oncology Physician
Primary
ME72379
FL
207RX0202X
Medical Oncology Physician
ME72379
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261657200
—
FL
01
—
830003154
RAILROAD MEDICARE
FL
Enumeration date
06/15/2006
Last updated
08/03/2015
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