MEDICARE: SHARI L 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	ME142588	FL
2	207ZP0007X	Molecular Genetic Pathology (Pathology) Physician	ME142588	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	19CRB	OTHER	NC	BCBS NC

General Provider Information

NPI Number	:	1720241813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARI L BROWN M.D.

Provider Business Mailing Address
First Line	:	12701 COMMONWEALTH DR STE 9
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-8626
Country	:	US
Telephone Number	:	866-776-5907
Fax Number	:	239-690-4237

Provider Business Practice Location Address
First Line	:	12701 COMMONWEALTH DR STE 9
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-8626
Country	:	US
Telephone Number	:	866-776-5907
Fax Number	:	239-690-4237

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

Provider Enumeration Date	:	07/08/2008
Last Update Date	:	04/13/2021

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