Healthcare Provider Details

I. General information

NPI: 1164609210
Provider Name (Legal Business Name): LEE BROWN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3840 COCONUT CREEK PARKWAY
COCONUT CREEK FL
33066
US

IV. Provider business mailing address

3410 STALLION LANE
WESTON FL
33331
US

V. Phone/Fax

Practice location:
  • Phone: 954-580-8867
  • Fax: 954-580-8942
Mailing address:
  • Phone: 954-659-9690
  • Fax: 954-659-9694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License NumberME100844
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: