Medi Brandon LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MEDI BRANDON LLC

Practice address

203 W Bloomingdale Ave
Brandon, FL 33511-7404

Phone

(813) 654-1110

NPI assigned

May 18, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas K Willett

Title

Managing Member

Phone

(813) 225-1051

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alexis Prickett Adams

  • Physician Assistant
  • Brandon, FL
  • NPI 1114493889
  NPD (past)
• Danielle Moncalieri, FNP-BC

  • Family Nurse Practitioner
  • Brandon, FL
  • NPI 1710376447
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475539200000",
    "number": "1033566161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 E MADISON ST",
            "address_2": "SUITE 1100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W BLOOMINGDALE AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335117404",
            "telephone_number": "813-654-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI BRANDON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-10-04",
        "status": "A",
        "authorized_official_last_name": "WILLETT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "813-225-1051"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Sheridan McVey
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• Med-Trans, LLC.
• Medi Plus Tampa LLC
• Medical Development and Support Corporation (Orthopaedics Center of Brandon)
• Medical Director Services Florida LLC
• Medical Health Group, PLLC
• Medical Home Alliance LLC (IMA Medica lGroup - Brandon)

• Family Medicine Physician in Brandon, FL
• Providers in Brandon, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.