Provider Demographics
NPI:1164499414
Name:BRINSON, ASHTON CHASE (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHTON
Middle Name:CHASE
Last Name:BRINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2515
Mailing Address - Country:US
Mailing Address - Phone:407-774-7080
Mailing Address - Fax:407-774-7090
Practice Address - Street 1:695 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2515
Practice Address - Country:US
Practice Address - Phone:407-774-7080
Practice Address - Fax:407-774-7090
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86123207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL62812UOtherMEDICARE
FL266079200Medicaid
FL266079200Medicaid