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Individual

BRANDI M JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
206 BUCKINGHAM PL, SUITE 101, BRANDON, FL 33511-4910
(813) 571-2977
(813) 654-9545
Mailing address
15815 SHADDOCK DR STE 130, WINTER GARDEN, FL 34787-5773
(407) 605-2321
(407) 671-4155

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO3199
FL
213EP1101X
Primary Podiatric Medicine Podiatrist
PO3199
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
PO3199
FL
213ES0131X
Foot Surgery Podiatrist
PO3199
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
202703
AMERIGROUP
FL
05
340534600
FL
01
65891
BCBS
FL
01
P00420517
RAILROAD MEDICARE
FL
01
PO3199
LICENSE NO
FL
Enumeration date
11/01/2006
Last updated
04/07/2026
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