Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1184025066 |
---|---|
Provider Name | Dr. Santarvis Brown |
First Address | Miami Gardens, FL 33055-3651 |
Second Address | Miami Gardens, FL 33055-3651 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2014 |
Last Update Date | 10/09/2014 |