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Individual

MICHAEL RYAN BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO, PA-C

Contact information

Practice address
11375 CORTEZ BLVD, BROOKSVILLE, FL 34613-5409
(352) 592-2757
Mailing address
11375 CORTEZ BLVD, BROOKSVILLE, FL 34613-5409

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
OS19319
FL
363AS0400X
Surgical Physician Assistant
PA9105765
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA9105765
PHYSICIAN ASSISTANT
FL
Enumeration date
11/24/2010
Last updated
12/08/2023
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