Provider Demographics
NPI:1033147830
Name:BROWN, DEBORAH ANN (MD,DMD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD,DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1993 COUNTY ROAD 1
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-2833
Mailing Address - Country:US
Mailing Address - Phone:727-738-1716
Mailing Address - Fax:727-738-0472
Practice Address - Street 1:1993 COUNTY ROAD 1
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-2833
Practice Address - Country:US
Practice Address - Phone:727-738-1716
Practice Address - Fax:727-738-0472
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN122791223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS55224Medicare UPIN
FL32602Medicare ID - Type Unspecified