MEDICARE: TRENACE BROWN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH22090	FL

General Provider Information

NPI Number	:	1124714779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRENACE BROWN

Provider Business Mailing Address
First Line	:	8303 MARK TWAIN PL
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33637-6314
Country	:	US
Telephone Number	:	813-403-0068
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 E ZACK ST STE 110-4257
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-3972
Country	:	US
Telephone Number	:	813-403-0068
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2023
Last Update Date	:	04/17/2023

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Directions to “ TRENACE BROWN ” Practice Location

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