Individual provider Active NPI

Mesadieu Branchelor, PA

  • Physician Assistant
  • Apopka, FL
National Provider Identifier
1639708373
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PACN55 Issued in FL
Practice address
425 S Hunt Club Blvd Ste 201
Apopka, FL 32703-2428
Phone
(407) 304-9337
NPI assigned
Apr 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PACN55 FL Primary
Physician Assistant 363A00000X 000390-P.A. PR

Addresses

Primary practice location

425 S Hunt Club Blvd Ste 201
Apopka, FL 32703-2428

Mailing address

425 S Hunt Club Blvd Ste 201
Apopka, FL 32703-2428
Phone (407) 304-9337

Other practice location 1

6336 W Colonial Dr
Orlando, FL 32818-7812
Phone (407) 259-2383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PACN55FLMDPhysician Assistant
000390-P.A.PRMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1585958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1639708373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 S HUNT CLUB BLVD STE 201",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327032428",
            "telephone_number": "407-304-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S HUNT CLUB BLVD STE 201",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327032428",
            "telephone_number": "407-304-9337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6336 W Colonial Dr",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328187812",
            "country_code": "US",
            "telephone_number": "407-259-2383",
            "fax_number": "833-450-5420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANCHELOR",
        "first_name": "MESADIEU",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-04",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PACN55",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PR",
            "license": "000390-P.A.",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.