Provider Demographics
NPI:1184025066
Name:BROWN, SANTARVIS
Entity Type:Individual
Prefix:DR
First Name:SANTARVIS
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17531 NW 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-3651
Mailing Address - Country:US
Mailing Address - Phone:786-412-4680
Mailing Address - Fax:305-430-0975
Practice Address - Street 1:17531 NW 47TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-3651
Practice Address - Country:US
Practice Address - Phone:786-412-4680
Practice Address - Fax:305-430-0975
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral