MEDICARE: JAMIE L BROWN PT

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	225100000X	Physical Therapist	PT25010	FL

General Provider Information

NPI Number	:	1295056448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE L BROWN PT

Provider Business Mailing Address
First Line	:	5830 CORAL RIDGE DR STE 120
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-3388
Country	:	US
Telephone Number	:	866-425-5768
Fax Number	:	888-308-1147

Provider Business Practice Location Address
First Line	:	5830 CORAL RIDGE DR STE 120
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-3388
Country	:	US
Telephone Number	:	866-425-5768
Fax Number	:	888-308-1147

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

Provider Enumeration Date	:	06/22/2010
Last Update Date	:	06/22/2010

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