Individual
DR. BRANDON EDWARD LOCKLEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 E STATE ROAD 434, LONGWOOD, FL 32750-5222
(407) 635-3026
(321) 203-4614
Mailing address
550 E STATE ROAD 434, LONGWOOD, FL 32750-5222
(407) 635-3026
(321) 203-4614
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
200800781
NC
207V00000X
Obstetrics & Gynecology Physician
Primary
ME132159
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022368
MEDICARE
—
05
—
5909548
—
NC
Enumeration date
05/20/2008
Last updated
05/26/2020
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