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General NPI Number Information
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NPI Number | 1376037549
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Entity Type | Individual
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Provider Name | BRANDON MONTANA APRN
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Gender | Male
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 91500 OVERSEAS HWY
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City | TAVERNIER
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State | FL
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Zip | 33070-2547
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Country | US
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Telephone | 305-434-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 3600 RED RD STE 401
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City | MIRAMAR
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State | FL
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Zip | 33025-6014
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Country | US
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Telephone | 919-357-7533
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN11038068
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5010631
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License Number State | NC
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