Provider Demographics
NPI:1821713371
Name:BROWN, MARQUS DEVONTE (DC)
Entity Type:Individual
Prefix:
First Name:MARQUS
Middle Name:DEVONTE
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 N SWALLOW TAIL DR APT 1803
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-4158
Mailing Address - Country:US
Mailing Address - Phone:662-907-8095
Mailing Address - Fax:
Practice Address - Street 1:3950 S US HIGHWAY 17/92 STE 1000
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-3289
Practice Address - Country:US
Practice Address - Phone:407-767-4878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14233111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor