Provider Demographics
NPI:1558350744
Name:BROWN, MICHAEL F (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:F
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 EAST COLONIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5245
Mailing Address - Country:US
Mailing Address - Phone:407-898-4427
Mailing Address - Fax:407-897-2108
Practice Address - Street 1:3901 EAST COLONIAL DRIVE
Practice Address - Street 2:SUITE D
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5245
Practice Address - Country:US
Practice Address - Phone:407-447-5971
Practice Address - Fax:407-447-5985
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0022655174400000X
FLME226552084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL054242300Medicaid
FL48811ZMedicare ID - Type Unspecified
FL054242300Medicaid