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NPI Code Detail

MEDICARE: MAKAYLA RENEE BRANTLEY

MEDICARE: MAKAYLA RENEE BRANTLEY
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
1106S00000XBehavior TechnicianFL

General Provider Information

NPI Number : 1750214953
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKAYLA RENEE BRANTLEY
Provider Business Mailing Address
First Line : 3100 SWEETBAY AVE APT 4318
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-2294
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4750 COLLEGIATE DR
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-1000
Country : US
Telephone Number : 850-770-2241
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2026
Last Update Date : 06/05/2026

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Directions to “ MAKAYLA RENEE BRANTLEY ” Practice Location

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