Provider Demographics
NPI:1184943409
Name:BROWN, BEVERLY Y
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:Y
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 245
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-5346
Mailing Address - Country:US
Mailing Address - Phone:407-285-6496
Mailing Address - Fax:407-339-9374
Practice Address - Street 1:274 WILSHIRE BLVD
Practice Address - Street 2:SUITE 245
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5346
Practice Address - Country:US
Practice Address - Phone:407-285-6496
Practice Address - Fax:407-339-9374
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator