Provider Demographics
NPI:1215465356
Name:BROWN DEAN, ANITA (OD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:
Last Name:BROWN DEAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2470 NW 108TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33167-3438
Mailing Address - Country:US
Mailing Address - Phone:305-517-1234
Mailing Address - Fax:954-252-4490
Practice Address - Street 1:8732 SUNSET DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3512
Practice Address - Country:US
Practice Address - Phone:305-595-8370
Practice Address - Fax:305-595-0012
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-02
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3560152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist