MEDICARE: MRS. BRENDA ANN COOPER ARNP

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	9175553	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN9175553	FL

General Provider Information

NPI Number	:	1871999508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRENDA ANN COOPER ARNP

Provider Business Mailing Address
First Line	:	2201 NW CORPORATE BLVD
Second Line	:	SUITE 202
City	:	BOCA RATON
State	:	FL
Zip	:	33431-7337
Country	:	US
Telephone Number	:	561-499-6933
Fax Number	:	561-235-5172

Provider Business Practice Location Address
First Line	:	1113 LINCOLN RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-5759
Country	:	US
Telephone Number	:	561-201-2230
Fax Number	:

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

Provider Enumeration Date	:	11/06/2014
Last Update Date	:	12/13/2023

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