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General NPI Number Information
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NPI Number | 1306947163
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Entity Type | Individual
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Provider Name | LISE D BROWN D.O.
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 6550 N FEDERAL HWY STE 320
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-1400
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Country | US
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Telephone | 954-500-7546
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Fax | 954-491-0562
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Provider Business Mailing Address
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Address Line | 801 YORK ST
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City | MANITOWOC
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State | WI
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Zip | 54220-4630
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Country | US
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Telephone | 920-663-9008
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Fax | 920-684-1439
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | OS9720
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License Number State | FL
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