Individual
BROOKE ALECIA RUPERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4710 N. HABANA AVENUE, SUITE #307, TAMPA, FL 33614-7151
(813) 874-2000
(813) 875-9303
Mailing address
5950 S FLORIDA AVE, LAKELAND, FL 33813-2532
(863) 688-3550
(863) 687-8969
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9339338
FL
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9339338
FL
Other
Enumeration date
03/22/2016
Last updated
02/20/2017
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