Provider Demographics
NPI:1457492860
Name:BROWN, SHARON LOUISE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LOUISE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2393 S CONGRESS AVE
Mailing Address - Street 2:STE 226
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7628
Mailing Address - Country:US
Mailing Address - Phone:561-862-5941
Mailing Address - Fax:
Practice Address - Street 1:4400 N FEDERAL HWY
Practice Address - Street 2:#210
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5187
Practice Address - Country:US
Practice Address - Phone:561-862-5941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 5445103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59884Medicare ID - Type UnspecifiedPY5445