Individual
BRANDON ANDREW SIMONETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1865 LPGA BLVD, DAYTONA BEACH, FL 32117-7108
(386) 255-4596
(386) 258-3561
Mailing address
1865 LPGA BLVD, DAYTONA BEACH, FL 32117-7108
(386) 255-4596
(386) 258-3561
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME162570
FL
207X00000X
Orthopaedic Surgery Physician
TRN25573
FL
207XS0117X
Orthopaedic Surgery of the Spine Physician
ME162570
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118194400
—
FL
Enumeration date
06/29/2017
Last updated
11/11/2024
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