DR. KEVIN PATRICK BRYAN M.D. NPI 1104811512

NPI Information

  • NPI: 1104811512
  • Provider Name: DR. KEVIN PATRICK BRYAN, M.D.
  • Classification: Pediatrics - 208000000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4200 SUN N LAKE BLVD
    SEBRING, FL
    ZIP 33872
  • Phone: (407) 975-0412

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NPI Details

DR. Kevin Patrick Bryan, M.D. is a pediatrics in Sebring, FL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Kevin Patrick Bryan, M.D. NPI is 1104811512. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4200 SUN N LAKE BLVD
SEBRING, FL
ZIP 33872-986
Phone: (407) 975-0412
Fax: (407) 975-0407

The NPI 1104811512 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/13/2005 and was last updated on 9/1/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsMD417302PENNSYLVANIANo
2208M00000XHospitalistME121818FLORIDANo
3208000000XPediatricsME121818FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1015608500MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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