Provider Demographics
NPI:1942240262
Name:BROWN, KYLE D (PAC)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:D
Last Name:BROWN
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 US HWY 1
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BCH
Mailing Address - State:FL
Mailing Address - Zip Code:33408
Mailing Address - Country:US
Mailing Address - Phone:561-840-1090
Mailing Address - Fax:561-840-0791
Practice Address - Street 1:733 US HWY 1
Practice Address - Street 2:ORTHOPAEDIC CARE SPECIALISTS
Practice Address - City:NORTH PALM BCH
Practice Address - State:FL
Practice Address - Zip Code:33408
Practice Address - Country:US
Practice Address - Phone:561-840-1090
Practice Address - Fax:561-840-0791
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9100680207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE1727ZMedicare PIN
S68612Medicare UPIN