Provider Demographics
NPI:1346680303
Name:SMITH, BRANDON J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:J
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 MAGUIRE BLVD
Mailing Address - Street 2:TARGET PHARMACY STORE NUMBER T-0649
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3706
Mailing Address - Country:US
Mailing Address - Phone:407-895-1025
Mailing Address - Fax:407-541-3400
Practice Address - Street 1:718 MAGUIRE BLVD
Practice Address - Street 2:TARGET PHARMACY STORE NUMBER T-0649
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3706
Practice Address - Country:US
Practice Address - Phone:407-895-1025
Practice Address - Fax:407-541-3400
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-04
Last Update Date:2013-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS50396183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist