Healthcare Provider Details

I. General information

NPI: 1649237546
Provider Name (Legal Business Name): LYLE E BROWNE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 S OLD DIXIE HWY
JUPITER FL
33458-7205
US

IV. Provider business mailing address

1210 S OLD DIXIE HWY
JUPITER FL
33458-7205
US

V. Phone/Fax

Practice location:
  • Phone: 561-263-4483
  • Fax: 561-263-2754
Mailing address:
  • Phone: 561-263-4483
  • Fax: 561-263-2754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberME 67223
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: