MEDICARE: JOHANNA PAOLA BROWN M.D.

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	207RI0200X	Infectious Disease Physician	0101239801	VA
2	207RI0200X	Infectious Disease Physician	A80763	CA
3	207RI0200X	Infectious Disease Physician	ME148976	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	197750	OTHER	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346243649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHANNA PAOLA BROWN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-424-1500
Fax Number	:	239-424-1423

Provider Business Practice Location Address
First Line	:	13340 METRO PKWY STE 310
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33966-4818
Country	:	US
Telephone Number	:	239-343-1448
Fax Number	:	239-343-4178

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	11/12/2021

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Directions to “ JOHANNA PAOLA BROWN M.D.” Practice Location

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