Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CH8036 | FL |
NPI | 1518965243 |
---|---|
Provider Name | Dr. Neil M Brown |
First Address | South Daytona, FL 32119-1860 |
Second Address | South Daytona, FL 32119-1860 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T95212 | (02) | FL |