Individual provider Active NPI

Michele Alexis Brandon, DO

  • Infectious Disease Physician
  • Jacksonville, FL
National Provider Identifier
1629636618
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
OS20944 Issued in FL
Practice address
8613 Old Kings Rd S Ste 602
Jacksonville, FL 32217-4863
Phone
(904) 493-3390
Fax
(904) 493-3395
NPI assigned
Jun 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X OS20944 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

8613 Old Kings Rd S Ste 602
Jacksonville, FL 32217-4863

Mailing address

653-1 W 8TH St
2ND FL LRC
Jacksonville, FL 32209-6511
Phone (904) 244-7514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250113002444 FL Practitioner - Infectious DiseasePractitioner - Internal Medicine 0345575981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Symphony Specialty Group, LLCGroup PAC ID 7719340850, 14 clinicians

Practice addresses (Care Compare)

8613 Old Kings Rd S
Suite 602
Jacksonville, FL 32217-4863
Phone (904) 493-3390

Hospital & facility affiliations

  • Mayo Clinic Hospital, Jacksonville, FL, CCN 100151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS20944FLMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Symphony Specialty Group, LLC Infectious Disease CurrentSince Jan 1, 2025 Accepting new patients
Jacksonville Hospitalists PA CurrentSince Jan 1, 2025 Accepting new patients

Locations

8613 Old Kings Rd S
Ste 602
Jacksonville, FL 32217
Phone (904) 493-3390

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1629636618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653-1 W 8TH ST",
            "address_2": "2ND FL LRC",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-7514",
            "fax_number": "904-244-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8613 OLD KINGS RD S STE 602",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174863",
            "telephone_number": "904-493-3390",
            "fax_number": "904-493-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "MICHELE",
        "middle_name": "ALEXIS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "OS20944",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.