Provider Demographics
NPI:1356622419
Name:BROWN, DAVID RAY (APRN)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RAY
Last Name:BROWN
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Gender:M
Credentials:APRN
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Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:239-599-2612
Practice Address - Street 1:19531 COCHRAN BLVD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-2081
Practice Address - Country:US
Practice Address - Phone:941-255-3535
Practice Address - Fax:941-766-7999
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2024-11-07
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Provider Licenses
StateLicense IDTaxonomies
NC5008652363L00000X
KY3007121363L00000X
FLAPRN11005845363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner