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Individual

MRS. JUANA MARISSA BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD, LD, MPH, CDE

Contact information

Practice address
4203 BELFORT RD STE 315, JACKSONVILLE, FL 32216
(904) 450-6860
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 296-5691
(904) 450-6401

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND3644
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
EV261Z
MEDICARE
FL
Enumeration date
12/16/2006
Last updated
08/23/2018
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