Individual
JACQUELINE BRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3100 E FLETCHER AVE, TAMPA, FL 33613-4613
(407) 303-7283
Mailing address
3100 E FLETCHER AVE, TAMPA, FL 33613-4613
(407) 303-7283
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11017680
FL
363LC0200X
Critical Care Medicine Nurse Practitioner
APRN11017680
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113771200
—
FL
01
—
B3YA8
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/14/2021
Last updated
03/12/2026
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