Individual
MR. CHARLES BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2145 METROCENTER BLVD STE 350, ORLANDO, FL 32835-7642
(407) 218-4800
Mailing address
8820 SOUTHERN BREEZE DR, ORLANDO, FL 32836-5011
(407) 810-7143
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
120417
FL
101YP1600X
Pastoral Counselor
—
FL
324500000X
Substance Abuse Rehabilitation Facility
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120417
INTERNATIONAL CERTIFICATION AND RECIPROCITY CONTINUUM
FL
01
—
800
CERTIFICATION BOARD OF ADDICTIONS PROFESSIONALS
FL
Enumeration date
05/10/2018
Last updated
05/10/2018
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