Provider Demographics
NPI:1891127189
Name:BROWN, TRISHA KAMIKA (MD)
Entity Type:Individual
Prefix:MS
First Name:TRISHA
Middle Name:KAMIKA
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1550 S WATER ST
Mailing Address - Street 2:
Mailing Address - City:STARKE
Mailing Address - State:FL
Mailing Address - Zip Code:32091-4511
Mailing Address - Country:US
Mailing Address - Phone:904-368-2489
Mailing Address - Fax:904-368-2484
Practice Address - Street 1:1550 S WATER ST
Practice Address - Street 2:
Practice Address - City:STARKE
Practice Address - State:FL
Practice Address - Zip Code:32091-4511
Practice Address - Country:US
Practice Address - Phone:904-368-2489
Practice Address - Fax:904-368-2484
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME124838208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program