Provider Demographics
NPI:1790949238
Name:PATRICIA W. BROWN, PHD, ARNP, LLC
Entity Type:Organization
Organization Name:PATRICIA W. BROWN, PHD, ARNP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:WHISONANT
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, ARNP
Authorized Official - Phone:407-737-9297
Mailing Address - Street 1:207 W. GORE STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806
Mailing Address - Country:US
Mailing Address - Phone:407-425-5100
Mailing Address - Fax:407-425-3009
Practice Address - Street 1:4421 SUN N LAKE BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-2166
Practice Address - Country:US
Practice Address - Phone:772-485-1058
Practice Address - Fax:863-655-2962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1104872364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL764346200Medicaid
FLY3541Medicare PIN
FL764346200Medicaid