Healthcare Provider Details

I. General information

NPI: 1013470988
Provider Name (Legal Business Name): BRANDON MICHAEL WILKINSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 WESTON RD
WESTON FL
33331-3602
US

IV. Provider business mailing address

5308 NW 92ND AVE
SUNRISE FL
33351-7720
US

V. Phone/Fax

Practice location:
  • Phone: 954-659-5000
  • Fax:
Mailing address:
  • Phone: 586-899-4047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number180454
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number313312
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: