MEDICARE: MR. BRANDON HOLSEY

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	347C00000X	Private Vehicle	SM672448	OH

General Provider Information

NPI Number	:	1467309765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRANDON HOLSEY

Provider Business Mailing Address
First Line	:	18432 LAKE SHORE BLVD APT 303
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44119-1260
Country	:	US
Telephone Number	:	440-907-9754
Fax Number	:

Provider Business Practice Location Address
First Line	:	18432 LAKE SHORE BLVD APT 303
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44119-1260
Country	:	US
Telephone Number	:	440-907-9754
Fax Number	:

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

Provider Enumeration Date	:	03/14/2026
Last Update Date	:	03/14/2026

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Directions to “ MR. BRANDON HOLSEY ” Practice Location

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