MEDICARE: MR. WILLIAM F BROWN P.T.C.

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	225100000X	Physical Therapist	23066	FL

General Provider Information

NPI Number	:	1801843040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM F BROWN P.T.C.

Provider Business Mailing Address
First Line	:	10130 AVONLEIGH DR
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34135-7019
Country	:	US
Telephone Number	:	443-742-4206
Fax Number	:

Provider Business Practice Location Address
First Line	:	10130 AVONLEIGH DR
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34135-7019
Country	:	US
Telephone Number	:	443-742-4206
Fax Number	:

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

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	10/21/2008

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