Provider Demographics
NPI:1477789824
Name:BROWN, JANICE C (MD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:C
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4881 NW 8TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4582
Mailing Address - Country:US
Mailing Address - Phone:352-416-1082
Mailing Address - Fax:352-373-6144
Practice Address - Street 1:3305 SW 34TH CIRCLE
Practice Address - Street 2:SUITE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-6617
Practice Address - Country:US
Practice Address - Phone:352-732-3110
Practice Address - Fax:352-732-0028
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127336208100000X, 208100000X
PAMT195528208100000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019325800Medicaid
PA30158346OtherAMERIHEALTH CARITAS - WMG
PA2898540OtherHIGHMARK BLUE SHIELD
PA30158346OtherAMERIHEALTH CARITAS - WMG