Provider Demographics
NPI:1932371952
Name:PAPE, BROOKE M (AUD)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:M
Last Name:PAPE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9711 COMMERCE CENTER CT
Mailing Address - Street 2:101
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-3817
Mailing Address - Country:US
Mailing Address - Phone:239-939-2621
Mailing Address - Fax:239-939-3875
Practice Address - Street 1:9711 COMMERCE CENTER CT
Practice Address - Street 2:101
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3817
Practice Address - Country:US
Practice Address - Phone:239-939-2621
Practice Address - Fax:239-939-3875
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY734231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01321828OtherRR MEDICARE
FLAK010XMedicare PIN