Provider Demographics
NPI:1720241813
Name:BROWN, SHARI L (MD)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12701 COMMONWEALTH DR STE 9
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8626
Mailing Address - Country:US
Mailing Address - Phone:866-776-5907
Mailing Address - Fax:239-690-4237
Practice Address - Street 1:12701 COMMONWEALTH DR STE 9
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8626
Practice Address - Country:US
Practice Address - Phone:866-776-5907
Practice Address - Fax:239-690-4237
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME142588207ZP0102X, 207ZP0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1720241813Medicaid
NC19CRBOtherBCBS NC
NCNC0249AMedicare PIN