Individual
DR. BRANDON ALAN MADIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
12550 NEW BRITTANY BLVD STE 100, FORT MYERS, FL 33907-3655
(239) 343-9180
(239) 343-9188
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9180
(239) 343-9188
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
OS12634
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022718400
—
FL
01
—
NR7MT
BCBS
FL
Enumeration date
06/17/2013
Last updated
03/29/2021
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