MEDICARE: BRANDI CIERA MYLES

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	106S00000X	Behavior Technician
2	225X00000X	Occupational Therapist	123583	TX

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	:	1942784350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI CIERA MYLES

Provider Business Mailing Address
First Line	:	6559 ARCHING BRANCH CIR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-8445
Country	:	US
Telephone Number	:	217-720-3813
Fax Number	:

Provider Business Practice Location Address
First Line	:	7005 PEPPERCORN CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-5530
Country	:	US
Telephone Number	:	217-720-3813
Fax Number	:

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

Provider Enumeration Date	:	09/20/2018
Last Update Date	:	01/17/2025

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Directions to “ BRANDI CIERA MYLES ” Practice Location

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