Healthcare Provider Details

I. General information

NPI: 1972214872
Provider Name (Legal Business Name): ANDREA INDRANI BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15735 SW 49TH CT
MIRAMAR FL
33027-4937
US

IV. Provider business mailing address

1380 NE MIAMI GARDENS DR STE 155
NORTH MIAMI BEACH FL
33179-4747
US

V. Phone/Fax

Practice location:
  • Phone: 954-558-0081
  • Fax:
Mailing address:
  • Phone: 305-431-2680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11005589
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: