Provider Demographics
NPI:1073578373
Name:BROWN, DAVID R (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11200 SW 8TH ST AHC1 ROOM 435
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33199-0001
Mailing Address - Country:US
Mailing Address - Phone:305-348-1379
Mailing Address - Fax:305-348-1494
Practice Address - Street 1:11200 SW 8TH ST AHC1 ROOM 435
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33199-2516
Practice Address - Country:US
Practice Address - Phone:305-348-1379
Practice Address - Fax:305-348-1494
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME83148207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262192400Medicaid
FL262192400Medicaid
FL03032Medicare ID - Type Unspecified