Provider Demographics
NPI:1558810820
Name:BROWNE, JANINA TANDOC (PA)
Entity Type:Individual
Prefix:
First Name:JANINA
Middle Name:TANDOC
Last Name:BROWNE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:JANINA
Other - Middle Name:
Other - Last Name:TANDOC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:3700 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6031
Practice Address - Country:US
Practice Address - Phone:954-276-5552
Practice Address - Fax:954-265-2570
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9116761363A00000X
ORPA179358363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116802200Medicaid