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NPI Code Detail

MEDICARE: DR. AMANDA LEIGH BROWN O.D.

MEDICARE:  DR. AMANDA LEIGH BROWN  O.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
1152WC0802XCorneal and Contact Management OptometristOPC4100FL
2152W00000XOptometristOPC4100FL

General Provider Information

NPI Number : 1508809559
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMANDA LEIGH BROWN O.D.
Provider Business Mailing Address
First Line : 30 TAVERNIER DR UNIT C
Second Line :
City : PONTE VEDRA
State : FL
Zip : 32081-0677
Country : US
Telephone Number : 904-686-2897
Fax Number : 904-834-2169
Provider Business Practice Location Address
First Line : 9525 CROSSHILL BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32222-5812
Country : US
Telephone Number : 904-573-9482
Fax Number : 904-573-9945
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 02/27/2025

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Directions to “ DR. AMANDA LEIGH BROWN O.D.” Practice Location

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