Provider Demographics
NPI:1922098045
Name:BROWN, ALAN L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:L
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1860 BOY SCOUT DR STE 201
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-2119
Mailing Address - Country:US
Mailing Address - Phone:239-215-1180
Mailing Address - Fax:239-215-1179
Practice Address - Street 1:15681 NEW HAMPSHIRE CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4123
Practice Address - Country:US
Practice Address - Phone:239-437-1977
Practice Address - Fax:239-437-1889
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME967692085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL56472OtherBCBS FL PROVIDER #
FL6331616OtherAETNA PROVIDER #
FLL3464OtherMEDICARE
FLP00370745OtherRAILROAD MEDICARE IND. #
FL276550100Medicaid
FL56472OtherBCBS FL PROVIDER #
FL276550100Medicaid
I11572Medicare UPIN