MEDICARE: DR. PAUL R 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	207W00000X	Ophthalmology Physician	ME11077	FL

General Provider Information

NPI Number	:	1659340917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL R BROWN M.D.

Provider Business Mailing Address
First Line	:	4225 EVANS AVE
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9311
Country	:	US
Telephone Number	:	239-936-8655
Fax Number	:	239-936-8683

Provider Business Practice Location Address
First Line	:	4225 EVANS AVE
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9311
Country	:	US
Telephone Number	:	239-936-8655
Fax Number	:	239-936-8683

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

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	07/09/2007

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