Provider Demographics
NPI:1164692463
Name:BROWN, JEANELLE DENISE (MD)
Entity type:Individual
Prefix:DR
First Name:JEANELLE
Middle Name:DENISE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OCEANS WEST BLVD APT 2000
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:32118-7945
Mailing Address - Country:US
Mailing Address - Phone:407-284-7419
Mailing Address - Fax:
Practice Address - Street 1:2 OCEANS WEST BLVD APT 2000
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH SHORES
Practice Address - State:FL
Practice Address - Zip Code:32118-7945
Practice Address - Country:US
Practice Address - Phone:407-284-7419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103239207L00000X
SD10521207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology