BRANDON CARTER MCDUFFIE (NPI# 1225289168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225289168 |
| Entity Type | Individual |
| Full Name | BRANDON CARTER MCDUFFIE |
| Credential | PA-C |
| Practice Address |
202 Lake Miriam Dr Ste 1 Lakeland FL 33813-2180 |
| Mailing Address |
151 Southhall Ln Ste 300 Maitland FL 32751-7172 |
| Practice Telephone | 8636472333 |
| Practice Fax Number | 8633931995 |
| Mailing Telephone | 4078752080 |
| Mailing Fax Number | 4076503455 |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2019-08-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9104516 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9104516 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 016128300 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12509 E Mission Ave, Suite 102, Spokane Valley, WA 992161049 | 5098922480 | 5098926708 |
| Street Address |
202 LAKE MIRIAM DR STE 1 |
| City | LAKELAND |
| State | FL |
| Zip Code | 33813-2180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700328515 | Elise Christine Bjelica | Nurse Practitioner | 202 Lake Miriam Dr Ste 1, Lakeland, FL 33813-2180 | 2016-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427600030 | Genesis Vieyra Lopez | Nurse Practitioner | 631 Mid Florida Drive, Lakeland, FL 33813 | 2019-07-13 |
| 1306323340 | Sandrene Smart | Clinic/Center | 625 Commerce Dr. (suite 103), Lakeland, FL 33813 | 2018-07-23 |
| 1033560586 | Charles D. Llano, D.d.s. | Dentist | 320 West Highland Drive, Lakeland, FL 33813 | 2016-06-27 |
| 1417317389 | Eye Specialists of Mid-florida, Pa | Ophthalmology | 2004 Cr 540 A, Lakeland, FL 33813 | 2016-03-04 |
| 1609234905 | Care and Life LLC | In Home Supportive Care | 6526 Fox Tree Lane, Lakeland, FL 33813 | 2016-02-02 |
| 1558731158 | Lori Ann Smith | Nurse Practitioner | 6030 S. Florida Ave, Suite 110, Lakeland, FL 33813 | 2015-09-25 |
| 1891182143 | Advanced Integrated Care Organization, LLC | Health Maintenance Organization | 5423 S. Florida Ave, Lakeland, FL 33813 | 2015-04-23 |
| 1902292352 | Central Health Associates | Internal Medicine | 4925 Old Rd 37, Lakeland, FL 33813 | 2015-04-13 |
| 1134542848 | Gledia Lovering | Dietitian, Registered | 6420 Highlands In The Woods St, Lakeland, FL 33813 | 2014-01-31 |
| 1134556368 | Billy Rogers | Nurse Anesthetist, Certified Registered | 4513 Orangewood Loop W., Lakeland, FL 33813 | 2013-10-02 |
| Find all providers in zip 33813 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609483619 | Melodey Aguirre | Physician Assistant | 3810 S Florida Ave Ste 120, Lakeland, FL 33813-1129 | 2020-09-24 |
| 1093321580 | Alison Palmer | Physician Assistant | 409 Aberdeen Ct N, Lakeland, FL 33813-1602 | 2020-09-20 |
| 1205448792 | Aditi Patel | Physician Assistant | 2151 Southern Oaks Ln, Lakeland, FL 33813-3197 | 2020-08-18 |
| 1780151605 | Leah Marie Carroll | Physician Assistant | 5216 Scotland Pl, Lakeland, FL 33813-3063 | 2018-10-29 |
| 1205327046 | Deniz Nebi | Physician Assistant | 1417 Lakeland Hills Blvd Ste 104, Lakeland, FL 33805-3200 | 2018-05-29 |
| 1568962017 | Gabriela Victoria Gamero | Physician Assistant | 6500 N Socrum Loop Rd # 100, Lakeland, FL 33809-4179 | 2018-02-20 |
| 1861845356 | Bethany Buisson | Physician Assistant | 9160 Highway 64 Ste 105, Lakeland, TN 38002-3011 | 2016-07-19 |
| 1841691136 | Colleen Morrison | Physician Assistant | 1610 Clarendon Ave, Lakeland, FL 33803-2506 | 2014-09-06 |
| 1003176322 | Nathaly Antigua Suarez | Physician Assistant | 1157 Thomasville Cir, Lakeland, FL 33811-3400 | 2012-05-21 |
| 1205126190 | Megan Marie Wagner | Physician Assistant | 4700 Research Way, Lakeland, FL 33805-8531 | 2011-04-12 |
| Find all providers in LAKELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.