MEDICARE: MR. JEFFREY ALAN BROWN LMT

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	208100000X	Physical Medicine & Rehabilitation Physician	55506	FL

General Provider Information

NPI Number	:	1417215005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY ALAN BROWN LMT

Provider Business Mailing Address
First Line	:	PO BOX 611501
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33261-1501
Country	:	US
Telephone Number	:	786-487-6043
Fax Number	:

Provider Business Practice Location Address
First Line	:	1626 NE 146TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33181-1344
Country	:	US
Telephone Number	:	786-487-6043
Fax Number	:

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

Provider Enumeration Date	:	05/02/2012
Last Update Date	:	05/02/2012

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