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NPI 1134955073

NPI 1134955073 : BRIAN KEITH BROWN JR. : GAINESVILLE, FL

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General NPI Number Information
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    NPI Number           |    1134955073
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    Entity Type          |    Individual 
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    Provider Name        |    BRIAN KEITH BROWN JR.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/09/2024
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    Last Update Date     |    12/16/2025
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Provider Practice Location Address
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    Address Line         |    4907 NW 43RD ST 
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    City                 |    GAINESVILLE
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    State                |    FL
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    Zip                  |    32606-2006
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    Country              |    US
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    Telephone            |    352-372-0047
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6517 NW 29TH ST 
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    City                 |    GAINESVILLE
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    State                |    FL
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    Zip                  |    32653-1443
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    RBT-24-371184
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    License Number State |    FL
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