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General NPI Number Information
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NPI Number | 1174821987
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Entity Type | Individual
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Provider Name | MR. BENJAMIN ALEXANDER BROWN
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Gender | Male
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Dates
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Enumeration Date | 03/02/2011
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Last Update Date | 03/02/2011
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Provider Practice Location Address
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Address Line | 572 SW 3RD ST APT 204
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City | BELLE GLADE
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State | FL
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Zip | 33430-3941
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Country | US
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Telephone | 561-993-9255
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Fax |
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Provider Business Mailing Address
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Address Line | 572 SW 3RD ST APT 204
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City | BELLE GLADE
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State | FL
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Zip | 33430-3941
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Country | US
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Telephone | 561-993-9255
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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