Individual
BRANDON WILSON
Active
Individual
BRANDON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
PA9107780
FL
363A00000X
Physician Assistant
PA9107780
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9107780
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122700900
—
FL
Enumeration date
01/17/2014
Last updated
07/28/2025
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