Individual
SUSAN A BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARDMS
Contact information
Practice address
501 NW LAKE WHITNEY PL, SUITE #106, PORT ST LUCIE, FL 34986-1615
(772) 785-8000
(772) 785-8150
Mailing address
501 NW LAKE WHITNEY PL, SUITE #106, PORT ST LUCIE, FL 34986-1615
(772) 785-8000
(772) 785-8150
Taxonomy
Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
14307
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
510001100
—
FL
01
—
V2026
BLUE SHIELD
FL
Enumeration date
07/31/2009
Last updated
08/05/2009
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