1407883358 NPI number — CARMEN BROWN M.D.

Table of content: CARMEN BROWN M.D. (NPI 1407883358)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407883358 NPI number — CARMEN BROWN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
CARMEN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407883358
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/04/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1277
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GURABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00778-1277
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-737-2311
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
32 CALLE RAFAEL LASA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AGUAS BUENAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00703-3212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-737-2311
Provider Business Practice Location Address Fax Number:
787-737-2311
Provider Enumeration Date:
06/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  23658 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 307386 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 90541 . This is a "BC BS OF FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 200023720A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 277713400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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