Provider Demographics
NPI:1619096153
Name:BROWN, ANDREW DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DAVID
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 1:2801 NW 87TH AVE
Mailing Address - Street 2:UNITE 7
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1603
Mailing Address - Country:US
Mailing Address - Phone:305-653-5155
Mailing Address - Fax:
Practice Address - Street 1:2801 NW 87TH AVE
Practice Address - Street 2:UNITE 7
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1603
Practice Address - Country:US
Practice Address - Phone:305-653-5155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME967682084N0400X
NY2296082084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK774ZMedicare PIN