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General NPI Number Information
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NPI Number | 1205925237
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Entity Type | Individual
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Provider Name | BRANDON LOUIS MEDNICK MD
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 18167 US HWY 19 NORTH SUITE 650
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City | CLEARWATER
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State | FL
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Zip | 33764-9843
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Country | US
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Telephone | 727-507-3643
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Fax | 727-507-3618
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Provider Business Mailing Address
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Address Line | 18167 US HIGHWAY 19 N STE 650
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City | CLEARWATER
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State | FL
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Zip | 33764-6576
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Country | US
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Telephone | 800-507-8874
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Fax | 727-507-3618
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 056138
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 01098122A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 96106
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License Number State | SC
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