Brandon Chan

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC6188 Issued in FL

Practice address

919 Lakeland Park Dr
Lakeland, FL 33809

Phone

(863) 859-6500

NPI assigned

Sep 22, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1689397861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 LYNN ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074501902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 LAKELAND PARK DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33809",
            "telephone_number": "863-859-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Chambers, MD
• Melissa Chambers, LMT
• Paul J Champino, APRN
• Yasmeen Alyssa Chan-Long, PA-C
• Jimmy C Chan-Pong, M.D.
• Nena Chancy, RD
• Grace Chandler, ISW17420
• Meghan Graham Chandler, MSW, RCSWI
• Chandler'S Helping Hands
• Sumita Chandran, M.D.

• Optometrist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.