Provider Demographics
NPI:1225790231
Name:FICARROTTA, BROOKE NATALIE (RN)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:NATALIE
Last Name:FICARROTTA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 CUMBERLAND CT E
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-4860
Mailing Address - Country:US
Mailing Address - Phone:727-215-3700
Mailing Address - Fax:
Practice Address - Street 1:1600 SW ARCHER RD UNIT 10-4
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:727-215-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9513306163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics