Provider Demographics
NPI:1467899161
Name:BROWN, ALEXIS M (PA)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 VANDERBILT BEACH RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-8708
Mailing Address - Country:US
Mailing Address - Phone:239-624-8220
Mailing Address - Fax:239-624-8221
Practice Address - Street 1:801 VANDERBILT BEACH RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-8708
Practice Address - Country:US
Practice Address - Phone:239-624-8220
Practice Address - Fax:239-624-8221
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601006667363A00000X
FLPA9108551363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIJ977VOtherMEDICARE
FLY0QL7OtherBCBS
FL016489800Medicaid