Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | ME0057554 | FL |
N | 207XS0106X | Orthopaedic Hand Surgeon | ME0057554 | FL |
NPI | 1083613533 |
---|---|
Provider Name | Dr. Mary Lynn Brown |
First Address | Winter Park, FL 32789-4949 |
Second Address | Winter Park, FL 32789-4949 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 04/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
064504400 | (05) | FL |
10414 | BC/BS (01) | FL |
200030017 | RAILROAD (01) | FL |
E51904 | (02) | FL |