Individual provider · NPI-1
Suzette Brockington
In Home Supportive Care · Valrico, FL
NPI number1033791504
StatusActive
Last updated in NPPESJun 9, 2021
Details
- NPI
- 1033791504
- Entity type
- Individual (NPI-1)
- Name
- Suzette Brockington
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 24, 2021
- Certification date
- Jun 9, 2021
- Last updated
- Jun 9, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
| 251E00000X | Home Health | – | – | |
| 372600000X | Adult Companion | – | – | |
| 376K00000X | Nurse's Aide | – | – | |
| 385HR2060X | Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | – | – |
Practice location
321 Benson StValrico, FL 33594-3014
Phone 813-562-4565 · Fax 813-354-4490
Mailing address
321 Benson StValrico, FL 33594-3014
Phone 813-562-4565 · Fax 813-354-4490
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