Healthcare Provider Details

I. General information

NPI: 1467099580
Provider Name (Legal Business Name): KERA LYN BROWNE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3268 FORUM BLVD STE 201
FORT MYERS FL
33905-5585
US

IV. Provider business mailing address

900 VILLAGE SQUARE XING STE 290
PALM BEACH GARDENS FL
33410-4552
US

V. Phone/Fax

Practice location:
  • Phone: 239-232-1176
  • Fax: 239-244-9839
Mailing address:
  • Phone: 239-313-2517
  • Fax: 239-313-2555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number11004846
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: