MEDICARE: BRANDON SHUTTY DO

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	207N00000X	Dermatology Physician	OS13979	FL
2	207ND0101X	MOHS-Micrographic Surgery Physician	OS13979	FL

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

General Provider Information

NPI Number	:	1598020059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON SHUTTY DO

Provider Business Mailing Address
First Line	:	7421 N UNIVERSITY DR STE 307
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-6102
Country	:	US
Telephone Number	:	954-720-7272
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 12TH ST STE 112
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-4087
Country	:	US
Telephone Number	:	305-363-4950
Fax Number	:	305-363-4951

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

Provider Enumeration Date	:	07/11/2012
Last Update Date	:	01/23/2026

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Directions to “ BRANDON SHUTTY DO” Practice Location

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