MEDICARE: SUSAN O'CONNOR 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	103TC0700X	Clinical Psychologist	PY11787	FL
2	103TC0700X	Clinical Psychologist	PS008999L	PA

General Provider Information

NPI Number	:	1720739394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN O'CONNOR BROWN

Provider Business Mailing Address
First Line	:	168 COASTAL OAK CIR
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-2702
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	168 COASTAL OAK CIR
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-2702
Country	:	US
Telephone Number	:	610-639-4554
Fax Number	:

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

Provider Enumeration Date	:	01/14/2022
Last Update Date	:	04/28/2026

Similar Medicare Providers

1568467264 — CITY OF HUNTINGTON BEACH
Practice Location Address:

2000 MAIN ST
HUNTINGTON BEACH, CA
92648-2702

Practice Phone: 714-374-1598
Practice Fax:

1447265574 — WALGREEN CO
Practice Location Address:

6006 BEACH BLVD
JACKSONVILLE, FL
32216-2702

Practice Phone: 904-727-6626
Practice Fax:

1396802377 — IMPERIAL BEACH FIRE DEPARTMENT
Practice Location Address:

865 IMPERIAL BEACH BLVD
IMPERIAL BEACH, CA
91932-2702

Practice Phone: 619-423-8223
Practice Fax:

1457494957 — THUY DIEU ROTUNDA MD
Practice Location Address:

1100 QUAIL ST STE 100A
NEWPORT BEACH, CA
92660-2702

Practice Phone: 949-608-9659
Practice Fax: 949-608-9659

1255452744 — RUBY LEE MCDONALD
Practice Location Address:

516 GOODWIN AVE
NEW SMYRNA BEACH, FL
32169-2702

Practice Phone: 386-689-5100
Practice Fax:

1821299306 — BARRY LOUIS EDELMAN M.D.
Practice Location Address:

2200 PACIFIC COAST HWY STE 304A
HERMOSA BEACH, CA
90254-2702

Practice Phone: 310-713-3180
Practice Fax:

Directions to “ SUSAN O'CONNOR BROWN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.