Provider Demographics
NPI:1477523256
Name:BRASINGTON, STEVE JOHNSON (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:JOHNSON
Last Name:BRASINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6307 SW 35TH WAY
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-5258
Mailing Address - Country:US
Mailing Address - Phone:466-699-3055
Mailing Address - Fax:
Practice Address - Street 1:4500 NEWBERRY RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2245
Practice Address - Country:US
Practice Address - Phone:352-351-6860
Practice Address - Fax:352-690-6954
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2023-09-18
Deactivation Date:2021-09-24
Deactivation Code:
Reactivation Date:2023-04-21
Provider Licenses
StateLicense IDTaxonomies
FLME783252084P0800X, 2084P0802X
VA01010401332084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAE85461Medicare UPIN