NPIMap

Individual provider Active NPI

Byron Renard Dean, DO

  • Family Medicine Physician
  • Lakeland, FL
National Provider Identifier
1104851559
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0S9203 Issued in FL
Practice address
1500 Lakeland Hills Blvd Ste 4
Lakeland, FL 33805
Phone
(863) 937-7157
Fax
(863) 333-0260
NPI assigned
Jul 12, 2006
Last updated
Apr 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0S9203 FL Primary

Addresses

Primary practice location

1500 Lakeland Hills Blvd Ste 4
Lakeland, FL 33805

Mailing address

3616 Harden Blvd
#311
Lakeland, FL 33803-5938
Phone (863) 937-7157

Other identifiers 4

IdentifierTypeStateIssuer
16757OtherBLUE CROSS
00396100ROtherFLMEDICAID GROUP #
EY656AOtherFLMEDICARE GROUP PTAN
245345600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051011000176 FL Practitioner - Family Practice 1658396494 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Medical IncGroup PAC ID 7810174711, 10 clinicians
Total Life Health Center LLLPGroup PAC ID 8921453127, 2 clinicians

Practice addresses (Care Compare)

1129 Lakeland Hills Blvd
Lakeland, FL 33805-4655
Phone (863) 594-2433

1500 Lakeland Hills Blvd
Suite 4
Lakeland, FL 33805-3257

215 Orange St
Suite 3
Auburndale, FL 33823-3447
Phone (863) 812-4334

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0S9203FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Total Life Health Center LLLP Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Total Life Health Center LLLP CurrentSince Mar 3, 2021 Accepting new patients
Sunshine Urgent Care, LLC CurrentSince Feb 1, 2016 Accepting new patients
Sunshine Urgent Care, LLC CurrentSince Feb 1, 2016 Accepting new patients
Evocare Wound Solutions PA CurrentSince Mar 1, 2025 Accepting new patients
Raypar Inc Past Accepting new patients
Raypar Inc Family Medicine Past Accepting new patients
Florida Presbyterian Homes, Inc. Past Accepting new patients
Lake Wales Operating Group LLC PastSince Jul 10, 2024 Accepting new patients

Locations

215 Orange St
Ste 3
Auburndale, FL 33823
Phone (863) 709-4933

1500 Lakeland Hills Blvd
Ste 4
Lakeland, FL 33805
Phone (863) 688-3674

3305 US Highway 98 S
Lakeland, FL 33803
Phone (863) 777-2740

7632 15th St E
Sarasota, FL 34243
Phone (312) 498-6616

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22535/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lake Wales Wellness and Rehabilitation CenterLake Wales, FL, CCN 106069 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 10, 2024
Mar 28, 2025
Bridgewalk on Harden Health and Rehabilitation LLCLakeland, FL, CCN 106138 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 10, 2021
Feb 20, 2026
Lake Mariam Health and Rehabilitation CenterWinter Haven, FL, CCN 105428 Skilled nursing facility Adp of the SNF Apr 1, 2023

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1104851559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3616 HARDEN BLVD",
            "address_2": "#311",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338035938",
            "telephone_number": "863-937-7157",
            "fax_number": "863-333-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LAKELAND HILLS BLVD STE 4",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-937-7157",
            "fax_number": "863-333-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "BYRON",
        "middle_name": "RENARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2023-04-12",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "0S9203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "16757",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP #",
            "identifier": "00396100R",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "EY656A",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "245345600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.