MEDICARE: PAULETTE K BROWN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	OTA13987	FL

General Provider Information

NPI Number	:	1164091609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULETTE K BROWN

Provider Business Mailing Address
First Line	:	PO BOX 561
Second Line	:
City	:	CLARCONA
State	:	FL
Zip	:	32710-0561
Country	:	US
Telephone Number	:	407-284-2845
Fax Number	:

Provider Business Practice Location Address
First Line	:	6808 MILL STREAM RD
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-8458
Country	:	US
Telephone Number	:	407-284-2845
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2021
Last Update Date	:	06/20/2021

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Directions to “ PAULETTE K BROWN ” Practice Location

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