Provider Demographics
NPI:1053675108
Name:BROWN, SARAH JANE (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:BROWN
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JANE
Other - Last Name:WILKINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1905 CLINT MOORE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2660
Mailing Address - Country:US
Mailing Address - Phone:561-757-5530
Mailing Address - Fax:561-430-5390
Practice Address - Street 1:1905 CLINT MOORE RD STE 202
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2660
Practice Address - Country:US
Practice Address - Phone:561-757-5530
Practice Address - Fax:561-430-5390
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015694363A00000X
TXPA10072363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03475830Medicaid
NY03475830Medicaid