Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | OS8984 | FL |
Y | 207PP0204X | Pediatric Emergency Physician | OS8984 | FL |
NPI | 1114963808 |
---|---|
Provider Name | Dr. Megan Leigh Brown |
First Address | Orlando, FL 32891-8025 |
Second Address | Gainesville, FL 32610-3003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 01/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
267622200 | (05) | FL |
81176 | BLUE SHIELD (01) | FL |
H94347 | (02) |