Provider Demographics
NPI:1073952909
Name:BRAZELL, MEREDITH JOHNSTON (DO)
Entity type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:JOHNSTON
Last Name:BRAZELL
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:LYNN
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 100296
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0296
Mailing Address - Country:US
Mailing Address - Phone:352-627-9350
Mailing Address - Fax:352-273-9054
Practice Address - Street 1:70 TURIN TER
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-0848
Practice Address - Country:US
Practice Address - Phone:904-819-2200
Practice Address - Fax:904-819-2201
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS15757208000000X
SC36085208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics