Provider Demographics
NPI:1982897112
Name:FLETCHER, BRANDON S (MD)
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:S
Last Name:FLETCHER
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 1:771 CIARA CREEK CV
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4659
Mailing Address - Country:US
Mailing Address - Phone:407-543-1270
Mailing Address - Fax:407-813-1311
Practice Address - Street 1:771 CIARA CREEK CV
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4659
Practice Address - Country:US
Practice Address - Phone:407-543-1270
Practice Address - Fax:407-813-1311
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115245207Q00000X
NC2011-00987208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist