Provider Demographics
NPI:1265184055
Name:BROWN, CASSANDRA LA-VERN
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:LA-VERN
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 1:2712 NW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-2161
Mailing Address - Country:US
Mailing Address - Phone:954-588-5376
Mailing Address - Fax:
Practice Address - Street 1:2716 NW 3RD ST
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-2161
Practice Address - Country:US
Practice Address - Phone:954-588-5376
Practice Address - Fax:754-205-5112
Is Sole Proprietor?:No
Enumeration Date:2022-01-22
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist