Individual
BRANDON BOGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1840 S WASHINGTON AVE, TITUSVILLE, FL 32780-4716
(321) 360-5577
(321) 806-2087
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 868-7272
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11016143
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114654100
—
FL
01
—
PG869
MEDICARE HF
FL
Enumeration date
05/20/2022
Last updated
09/21/2023
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