MEDICARE: MR. ALFRED HERBERT BRANDON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	ME 41813	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	P01652208	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8506999	OTHER	FL	CIGNA
3	1235675	OTHER	FL	WELLCARE
4	9714	OTHER	FL	DIMENSION
5	P954201	OTHER	FL	OPTIMUM
6	5617106	OTHER	FL	AETNA
8	P1015358	OTHER	FL	FREEDOM
9	210538	OTHER	FL	AVMED
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225025380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALFRED HERBERT BRANDON MD

Provider Business Mailing Address
First Line	:	2234 COLONIAL BLVD
Second Line	:	ATTN: PAYER CONTRACTING & RELATIONS
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1412
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	6030 HOLLYWOOD BLVD
Second Line	:	SUITE 100
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-7964
Country	:	US
Telephone Number	:	954-322-7200
Fax Number	:	954-322-7203

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	08/27/2024

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