Individual
GLADYS BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 NW 139TH ST, MIAMI, FL 33168-6711
(305) 687-2215
Mailing address
1101 NW 139TH ST, MIAMI, FL 33168-6711
(305) 687-2215
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
CFCE 1007-1014-92
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300094000
MEDICAID PROVIDER NUMBER
FL
Enumeration date
04/22/2008
Last updated
04/22/2008
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