Provider Demographics
NPI:1598887010
Name:BROWN, JON ROBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:ROBERT
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1400 SE GOLDTREE DR STE 103
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7582
Mailing Address - Country:US
Mailing Address - Phone:772-335-8446
Mailing Address - Fax:772-335-8499
Practice Address - Street 1:1400 SE GOLDTREE DR STE 103
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7582
Practice Address - Country:US
Practice Address - Phone:772-335-8446
Practice Address - Fax:772-335-8499
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101016366208600000X
IN02004106A2086S0127X
FLOS14288208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery