Provider Demographics
NPI:1225661432
Name:STERANKO, BROOKE
Entity Type:Individual
Prefix:MS
First Name:BROOKE
Middle Name:
Last Name:STERANKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5426 KUMQUAT LOOP
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-3152
Mailing Address - Country:US
Mailing Address - Phone:407-409-1012
Mailing Address - Fax:
Practice Address - Street 1:5426 KUMQUAT LOOP
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-3152
Practice Address - Country:US
Practice Address - Phone:407-409-1012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11004794363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily