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General NPI Number Information
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NPI Number | 1235013558
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Entity Type | Individual
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Provider Name | NICOLE BROWN
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Gender | Female
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 9225 MILEY DR STE 100
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City | WINTER GARDEN
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State | FL
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Zip | 34787-0113
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Country | US
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Telephone | 407-347-2620
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Fax |
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Provider Business Mailing Address
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Address Line | 3080 ROBERTS RD
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City | ASTON
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State | PA
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Zip | 19014-2853
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Country | US
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Telephone | 610-357-4876
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9120619
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License Number State | FL
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