Healthcare Provider Details

I. General information

NPI: 1346383924
Provider Name (Legal Business Name): THOMAS PAUL BROWN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S UNIVERSITY DR
DAVIE FL
33328-2018
US

IV. Provider business mailing address

2100 S OCEAN DR APT 4B
FORT LAUDERDALE FL
33316-3841
US

V. Phone/Fax

Practice location:
  • Phone: 954-262-5590
  • Fax:
Mailing address:
  • Phone: 850-206-6464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS5745
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOS0005745
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: