MEDICARE: ABIGAIL ANGELLA 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

General Provider Information

NPI Number	:	1467339564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL ANGELLA BROWN

Provider Business Mailing Address
First Line	:	5249 MILLENIA BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-6173
Country	:	US
Telephone Number	:	321-806-0858
Fax Number	:

Provider Business Practice Location Address
First Line	:	4945 S ORANGE BLOSSOM TRL
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-2381
Country	:	US
Telephone Number	:	407-964-1440
Fax Number	:

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

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	08/19/2025

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