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General NPI Number Information
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NPI Number | 1992409460
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Entity Type | Individual
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Provider Name | BRANDON RAYNE VERDONI MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2023
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Last Update Date | 02/08/2026
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Provider Practice Location Address
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Address Line | 13677 W MCDOWELL RD
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City | GOODYEAR
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State | AZ
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Zip | 85395-2635
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Country | US
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Telephone | 623-882-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 1048 N 90TH PL
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City | MESA
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State | AZ
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Zip | 85207-5136
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Country | US
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Telephone | 480-280-2069
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | R81788
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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