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NPI Code Detail

MEDICARE: JOAN EDNA BROWN D.P.M.

MEDICARE: JOAN EDNA BROWN D.P.M.
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
1213E00000XPodiatristPO1758FL

General Provider Information

NPI Number : 1144477696
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN EDNA BROWN D.P.M.
Provider Business Mailing Address
First Line : 2521 COUNTRYSIDE BLVD
Second Line :
City : CLEARWATER
State : FL
Zip : 33763-1605
Country : US
Telephone Number : 727-797-5008
Fax Number : 727-791-8517
Provider Business Practice Location Address
First Line : 2521 COUNTRYSIDE BLVD
Second Line :
City : CLEARWATER
State : FL
Zip : 33763-1605
Country : US
Telephone Number : 727-797-5008
Fax Number : 727-791-8517
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2008
Last Update Date : 08/26/2008

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