Provider Demographics
NPI:1669249124
Name:BROWN, JOHN D
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 NORTHPOINT PKWY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BCH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-1951
Mailing Address - Country:US
Mailing Address - Phone:601-551-0278
Mailing Address - Fax:
Practice Address - Street 1:132 N 11TH ST
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-2736
Practice Address - Country:US
Practice Address - Phone:601-551-0278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician