Provider Demographics
NPI:1306947163
Name:BROWN, LISE D (DO)
Entity type:Individual
Prefix:DR
First Name:LISE
Middle Name:D
Last Name:BROWN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:6550 N FEDERAL HWY STE 320
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1400
Practice Address - Country:US
Practice Address - Phone:954-500-7546
Practice Address - Fax:954-491-0562
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS9720207N00000X
OK8224207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology