MEDICARE: DR. THOMAS D 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	2085R0202X	Diagnostic Radiology Physician	ME62144	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	17851Z	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972557783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS D BROWN M.D.

Provider Business Mailing Address
First Line	:	500 S BEACH ST APT F1
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-5024
Country	:	US
Telephone Number	:	321-439-1477
Fax Number	:

Provider Business Practice Location Address
First Line	:	7524 CYPRESS GARDENS BLVD
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-3200
Country	:	US
Telephone Number	:	863-535-5544
Fax Number	:

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	07/21/2022

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