Provider Demographics
NPI:1437672417
Name:BROWN, KATIE-MARIE PATSY (OD)
Entity Type:Individual
Prefix:DR
First Name:KATIE-MARIE
Middle Name:PATSY
Last Name:BROWN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 VILLAGE CENTER DR APT 305
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-2889
Mailing Address - Country:US
Mailing Address - Phone:508-688-7679
Mailing Address - Fax:
Practice Address - Street 1:11391 CAUSEWAY BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-2904
Practice Address - Country:US
Practice Address - Phone:813-413-3202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-20
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5450152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist