Provider Demographics
NPI:1689606030
Name:BRANDT, JOHN F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:BRANDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:FREDERICK
Other - Last Name:BRANDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5200 NW 43RD ST
Mailing Address - Street 2:SUITE 102, #387
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-4484
Mailing Address - Country:US
Mailing Address - Phone:352-328-1529
Mailing Address - Fax:352-548-4801
Practice Address - Street 1:5200 NW 43RD ST
Practice Address - Street 2:SUITE 102, #387
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-4484
Practice Address - Country:US
Practice Address - Phone:352-328-1529
Practice Address - Fax:352-548-4801
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77318207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265444000Medicaid
FLE2542Medicare ID - Type Unspecified
FL265444000Medicaid