Individual
SUZETTE BROCKINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
321 BENSON ST, VALRICO, FL 33594-3014
(813) 562-4565
(813) 354-4490
Mailing address
321 BENSON ST, VALRICO, FL 33594-3014
(813) 562-4565
(813) 354-4490
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
372600000X
Adult Companion
—
—
376K00000X
Nurse's Aide
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014362400
—
FL
Enumeration date
04/24/2021
Last updated
06/09/2021
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