MEDICARE: CHRISTINA JOY BROWN P.A.

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	363A00000X	Physician Assistant	PA9100877	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0664623	OTHER	FL	AETNA PPO
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	592207264E	OTHER	FL	HUMANA
4	0905258	OTHER	FL	UHC
5	592207264	OTHER	FL	CIGNA PPO
6	0599681	OTHER	FL	GHI PPO
7	36291	OTHER	FL	BCBS
8	4130734	OTHER	FL	AETNA HMO
9	1716925002	OTHER	FL	CIGNA HMO

General Provider Information

NPI Number	:	1205888559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA JOY BROWN P.A.

Provider Business Mailing Address
First Line	:	3210 CLEVELAND AVE STE 100
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-7182
Country	:	US
Telephone Number	:	239-936-6778
Fax Number	:	239-277-3273

Provider Business Practice Location Address
First Line	:	3210 CLEVELAND AVE STE 100
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-7182
Country	:	US
Telephone Number	:	239-936-6778
Fax Number	:	239-277-3273

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	04/08/2010

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