Provider Demographics
NPI:1740479500
Name:BROWN, MONICA MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 BELFORT RD BLDG 600
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6038
Mailing Address - Country:US
Mailing Address - Phone:904-739-2050
Mailing Address - Fax:904-733-3304
Practice Address - Street 1:5150 BELFORT RD BLDG 600
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6038
Practice Address - Country:US
Practice Address - Phone:904-739-2050
Practice Address - Fax:904-733-3304
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4282152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBH027ZMedicare UPIN
FL1740479500Medicare NSC
FL1376964460Medicare NSC