MEDICARE: INEZ DAVIS COOKE APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11035486	FL

General Provider Information

NPI Number	:	1841011194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INEZ DAVIS COOKE APRN

Provider Business Mailing Address
First Line	:	10120 COUNT FLEET DR
Second Line	:
City	:	RUSKIN
State	:	FL
Zip	:	33573-6771
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2605 W SWANN AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4039
Country	:	US
Telephone Number	:	813-874-5500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2024
Last Update Date	:	02/22/2026

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