Healthcare Provider Details

I. General information

NPI: 1306371794
Provider Name (Legal Business Name): RAMI BROWN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2017
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 NW 6TH ST
GAINESVILLE FL
32601-4020
US

IV. Provider business mailing address

126 WHITE FAWN DR
DAYTONA BEACH FL
32114-1459
US

V. Phone/Fax

Practice location:
  • Phone: 352-373-4411
  • Fax: 352-373-4455
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number005461400
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: