MEDICARE: MR. KYLE D BROWN PAC

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	207X00000X	Orthopaedic Surgery Physician	PA9100680	FL

General Provider Information

NPI Number	:	1942240262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KYLE D BROWN PAC

Provider Business Mailing Address
First Line	:	733 US HWY 1
Second Line	:
City	:	NORTH PALM BCH
State	:	FL
Zip	:	33408
Country	:	US
Telephone Number	:	561-840-1090
Fax Number	:	561-840-0791

Provider Business Practice Location Address
First Line	:	733 US HWY 1
Second Line	:	ORTHOPAEDIC CARE SPECIALISTS
City	:	NORTH PALM BCH
State	:	FL
Zip	:	33408
Country	:	US
Telephone Number	:	561-840-1090
Fax Number	:	561-840-0791

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	03/11/2008

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