Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | ME77318 | FL |
NPI | 1689606030 |
---|---|
Provider Name | Dr. John F Brandt |
First Address | Gainesville, FL 32606-4484 |
Second Address | Gainesville, FL 32606-4484 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 11/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
265444000 | (05) | FL |
G93805 | (02) |