Provider Demographics
NPI:1417740630
Name:HALL-BROWN, CASANDERA (PHLEBOTOMY ,LPN)
Entity type:Individual
Prefix:
First Name:CASANDERA
Middle Name:
Last Name:HALL-BROWN
Suffix:
Gender:F
Credentials:PHLEBOTOMY ,LPN
Other - Prefix:
Other - First Name:CASANDERA
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:11232 BOYETTE RD UNIT 2083
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-8009
Mailing Address - Country:US
Mailing Address - Phone:813-563-2341
Mailing Address - Fax:
Practice Address - Street 1:12902 PRESTWICK DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-7002
Practice Address - Country:US
Practice Address - Phone:817-909-4996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNPCN-17379-11810246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy