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Individual

BRANDON TRAGESER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
4121 W HIGHWAY 98, PANAMA CITY, FL 32401-1170
(850) 914-7060
(850) 914-7065
Mailing address
PO BOX 2699, PENSACOLA, FL 32513-2699
(850) 475-4686
(850) 475-4619

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9105986
FL
363A00000X
Physician Assistant
PAT9105986
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
021361300
FL
Enumeration date
06/13/2011
Last updated
08/07/2019
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