Healthcare Provider Details

I. General information

NPI: 1366379463
Provider Name (Legal Business Name): ROBERT LEE BROWN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2232 VINE ST APT 322
CINCINNATI OH
45219-1828
US

IV. Provider business mailing address

2232 VINE ST APT 322
CINCINNATI OH
45219-1828
US

V. Phone/Fax

Practice location:
  • Phone: 216-513-3980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: