Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | OS0005745 | FL |
NPI | 1346383924 |
---|---|
Provider Name | Dr. Thomas Paul Brown |
First Address | Fort Lauderdale, FL 33316-3841 |
Second Address | Davie, FL 33328-2018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 31/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAD000 | (02) | FL |