Individual
DR. TEDDY WALLACE BROWN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13910 FIVAY ROAD SUITE 12, HUDSON, FL 34667
(727) 861-0678
(727) 861-0679
Mailing address
13910 FIVAY ROAD SUITE 12, HUDSON, FL 34667
(727) 861-0678
(727) 861-0679
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME85915
FL
207Y00000X
Otolaryngology Physician
TP896
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265323100
—
FL
Enumeration date
12/16/2005
Last updated
10/04/2021
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