Healthcare Provider Details

I. General information

NPI: 1912884057
Provider Name (Legal Business Name): LAYNE M BROWN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 7TH AVE N
ST PETERSBURG FL
33705-1388
US

IV. Provider business mailing address

5005 NEWTON AVE S
GULFPORT FL
33707-4309
US

V. Phone/Fax

Practice location:
  • Phone: 727-825-1100
  • Fax:
Mailing address:
  • Phone: 727-251-4890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN9619352
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: