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General NPI Number Information
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NPI Number | 1922892801
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Entity Type | Organization
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Legal Business Name | STONEBRAKER MEDICAL, LLC
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 1922 VICTORIA AVE STE A
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City | FORT MYERS
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State | FL
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Zip | 33901-3441
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Country | US
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Telephone | 239-699-1082
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Fax | 239-984-8873
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Provider Business Mailing Address
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Address Line | 2034 SE 25TH TER
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City | CAPE CORAL
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State | FL
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Zip | 33904-3238
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Country | US
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Telephone | 304-582-1990
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Fax | 239-984-8873
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MARY ELIZABETH STONEBRAKER
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Credential | NP-C
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Telephone | 239-699-1082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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