Organization
LYLE BREEDING MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYLE G BREEDING MD (AUTHORIZED OFFICIAL)
(352) 597-3444
Entity
Organization
Contact information
Practice address
11373 CORTEZ BLVD, SUITE 202, BROOKSVILLE, FL 34613-5414
(352) 597-3444
Mailing address
11373 CORTEZ BLVD, SUITE 202, BROOKSVILLE, FL 34613-5414
(352) 597-3444
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME102374
FL
2086S0129X
Vascular Surgery Physician
ME102374
FL
Other
Enumeration date
08/18/2008
Last updated
08/19/2008
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