Individual
JAMES CORNELIUS BROWN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
24420 SR 54, LUTZ, FL 33559-7303
(813) 949-4100
(813) 949-4144
Mailing address
918 STALLION WAY, VALRICO, FL 33594-4396
(813) 546-6891
(813) 657-8893
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9100900
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E2336Q
MEDICARE PTAN LINKED TO GROUP PTAN GA609A
FL
Enumeration date
07/02/2007
Last updated
10/22/2012
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