Provider Demographics
NPI:1649267972
Name:BYJU, KR (MD)
Entity type:Individual
Prefix:
First Name:KR
Middle Name:
Last Name:BYJU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KIZHAKEVILAYIL
Other - Middle Name:R
Other - Last Name:BYJU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2401 UNIVERSITY PKWY
Mailing Address - Street 2:STE 202
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2893
Mailing Address - Country:US
Mailing Address - Phone:941-360-2579
Mailing Address - Fax:941-360-2580
Practice Address - Street 1:2401 UNIVERSITY PKWY
Practice Address - Street 2:STE 202
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243
Practice Address - Country:US
Practice Address - Phone:941-360-2579
Practice Address - Fax:941-360-2580
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83308207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME83308OtherME NUMBER
FL13743OtherBCBS
2206358OtherUHC
1339812001OtherCIGNA
01547OtherUNIVERSAL
FL2744403OtherAETNA
FL2744403OtherAETNA
ME83308OtherME NUMBER
2206358OtherUHC