Healthcare Provider Details

I. General information

NPI: 1043154115
Provider Name (Legal Business Name): BRANDON AUGUSTINE HEVIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W 68TH ST
HIALEAH FL
33016-1898
US

IV. Provider business mailing address

6541 SW 61ST TER
SOUTH MIAMI FL
33143-2010
US

V. Phone/Fax

Practice location:
  • Phone: 305-823-5000
  • Fax:
Mailing address:
  • Phone: 305-546-6814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: