Provider Demographics
NPI:1053070482
Name:BROWN, MICHELLE T (APRN, AGNP-C)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:T
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7860 PETERS RD STE F101
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4026
Mailing Address - Country:US
Mailing Address - Phone:954-820-7480
Mailing Address - Fax:954-820-7485
Practice Address - Street 1:7860 PETERS RD STE F101
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-4026
Practice Address - Country:US
Practice Address - Phone:954-820-7480
Practice Address - Fax:954-820-7485
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016986363LA2200X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology