MEDICARE: REBECCA BROWN IMH

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	17824	FL

General Provider Information

NPI Number	:	1578020954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA BROWN IMH

Provider Business Mailing Address
First Line	:	14135 CYPRESS CIR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2714
Country	:	US
Telephone Number	:	630-802-5935
Fax Number	:

Provider Business Practice Location Address
First Line	:	6938 W LINEBAUGH AVE STE 101
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-5824
Country	:	US
Telephone Number	:	630-802-5935
Fax Number	:

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

Provider Enumeration Date	:	02/21/2019
Last Update Date	:	06/16/2025

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