Individual
BRANDY C. WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2646 CENTENNIAL PL STE A, TALLAHASSEE, FL 32308-0573
(850) 702-0300
(850) 325-6015
Mailing address
PO BOX 12427, TALLAHASSEE, FL 32317-2427
(850) 297-0114
(850) 297-2020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME103588
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002105700
—
FL
Enumeration date
06/20/2007
Last updated
10/12/2022
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