Provider Demographics
NPI:1649452376
Name:BROWN, CATHERINE S (MSPT)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:S
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4224 MIDDLEBROOK RD
Mailing Address - Street 2:APT. 522
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-6788
Mailing Address - Country:US
Mailing Address - Phone:407-701-9346
Mailing Address - Fax:
Practice Address - Street 1:201 THORNBERRY BRANCH LN
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32124-3652
Practice Address - Country:US
Practice Address - Phone:386-872-4892
Practice Address - Fax:386-256-2320
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26027225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002966209Medicaid