Provider Demographics
NPI:1437112562
Name:BROWN, DEBORAH LEANNE (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LEANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:LEANNE
Other - Last Name:BISHOP-BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2268 SEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-2973
Mailing Address - Country:US
Mailing Address - Phone:970-379-7541
Mailing Address - Fax:
Practice Address - Street 1:3450 11TH CT STE 201
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5012
Practice Address - Country:US
Practice Address - Phone:772-794-3364
Practice Address - Fax:772-794-3366
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35095207Q00000X
FLME132747207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022613000Medicaid
CO01350958Medicaid
COG47096Medicare UPIN