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NPI Code Detail

MEDICARE: BRANDI M JOHNSON DPM

MEDICARE:   BRANDI M JOHNSON  DPM
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
1213ES0103XFoot & Ankle Surgery PodiatristPO3199FL
2213E00000XPodiatristPO3199FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5P00420517OTHERFLRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1202703OTHERFLAMERIGROUP
265891OTHERFLBCBS
3PO3199OTHERFLLICENSE NO
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639257207
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDI M JOHNSON DPM
Provider Business Mailing Address
First Line : 15815 SHADDOCK DR STE 130
Second Line :
City : WINTER GARDEN
State : FL
Zip : 34787-5773
Country : US
Telephone Number : 407-605-2321
Fax Number : 407-671-4155
Provider Business Practice Location Address
First Line : 206 BUCKINGHAM PL
Second Line : SUITE 101
City : BRANDON
State : FL
Zip : 33511-4910
Country : US
Telephone Number : 813-571-2977
Fax Number : 813-654-9545
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 04/07/2026

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Directions to “ BRANDI M JOHNSON DPM” Practice Location

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