Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN12279 | FL |
NPI | 1033147830 |
---|---|
Provider Name | Dr. Deborah Ann Brown |
First Address | Dunedin, FL 34698-2833 |
Second Address | Dunedin, FL 34698-2833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S55224 | (02) | FL |