Provider Demographics
NPI:1477621829
Name:BROWN, C DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:C
Middle Name:DEAN
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4247 W KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2230
Mailing Address - Country:US
Mailing Address - Phone:813-289-5575
Mailing Address - Fax:813-289-5565
Practice Address - Street 1:4247 W KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2230
Practice Address - Country:US
Practice Address - Phone:813-289-5575
Practice Address - Fax:813-289-5565
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8527111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88371Medicare ID - Type Unspecified