Healthcare Provider Details

I. General information

NPI: 1134983166
Provider Name (Legal Business Name): ALVIN RAY BROWN APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2024
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 16TH ST
VERO BEACH FL
32960-3625
US

IV. Provider business mailing address

1406 16TH ST
VERO BEACH FL
32960-3625
US

V. Phone/Fax

Practice location:
  • Phone: 772-783-4223
  • Fax:
Mailing address:
  • Phone: 772-783-4223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberAPRN11031170
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberAPRN11031170
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11031170
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11031170
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: