Healthcare Provider Details

I. General information

NPI: 1720613201
Provider Name (Legal Business Name): LILA BRODIE DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2020
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 N KROME AVE STE 401
HOMESTEAD FL
33030-4443
US

IV. Provider business mailing address

950 N KROME AVE STE 401
HOMESTEAD FL
33030-4443
US

V. Phone/Fax

Practice location:
  • Phone: 305-248-0874
  • Fax:
Mailing address:
  • Phone: 305-248-0874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11000718
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11000718
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: