Provider Demographics
NPI:1689996894
Name:BROWN, CAREN LEIGH (RD, LD/N, CDE)
Entity Type:Individual
Prefix:MS
First Name:CAREN
Middle Name:LEIGH
Last Name:BROWN
Suffix:
Gender:F
Credentials:RD, LD/N, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16979 SE 81ST CHARLESFORT AVE
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-8373
Mailing Address - Country:US
Mailing Address - Phone:352-494-6882
Mailing Address - Fax:888-408-8296
Practice Address - Street 1:1580 SANTA BARBARA BLVD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-6827
Practice Address - Country:US
Practice Address - Phone:352-494-6882
Practice Address - Fax:888-408-8296
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2015-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4062133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL636002OtherAMERICAN DIETETIC ASSOCIATION