Individual
DR. BRANDON J KAMBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14534 OLD SAINT AUGUSTINE RD STE 3210, JACKSONVILLE, FL 32258-2645
(904) 880-1260
(904) 880-1210
Mailing address
1325 SAN MARCO BLVD STE 200, JACKSONVILLE, FL 32207-8566
(904) 376-3707
(904) 880-1210
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
ME96051
FL
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
ME96051
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275979900
—
FL
01
—
P00345043
RAILROAD MEDICARE
FL
Enumeration date
06/18/2006
Last updated
04/15/2021
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