Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | ME60769 | FL |
NPI | 1093767550 |
---|---|
Provider Name | Dr. Mark Brown |
First Address | Naples, FL 34102-5400 |
Second Address | Naples, FL 34102-5400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
25993 | BCBS (01) | FL |
25993Y | MEDICARE (01) | FL |
376120700 | (05) | FL |
F90014 | (02) | FL |