Individual provider Active NPI

Brooklyn Nicole Coleman

  • Nurse Practitioner
  • Riverview, FL
National Provider Identifier
1083437651
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11034996 Issued in FL
Practice address
2115 Kings Palace Dr
Riverview, FL 33578-2131
Phone
(813) 724-8942
NPI assigned
Nov 4, 2024
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11034996 FL Primary

Addresses

Primary practice location

2115 Kings Palace Dr
Riverview, FL 33578-2131

Mailing address

2115 Kings Palace Dr
Riverview, FL 33578-2131
Phone (813) 724-8942

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250321000008 FL Practitioner - Nurse Practitioner 5496277261 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tampa Family Specialty Services LLCGroup PAC ID 4284163718, 2 clinicians

Practice addresses (Care Compare)

2727 W Dr Martin Luther King Jr Blvd
Suite 100
Tampa, FL 33607-6353

2727 W MLK Blvd
Suite 100a
Tampa, FL 33607-6353
Phone (813) 397-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11034996FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Infusion, LLC CurrentSince Jan 2, 2025 Accepting new patients
Tampa Family Specialty Services LLC Nurse Practitioner CurrentSince Mar 1, 2025 Accepting new patients
Tampa Family Health Centers Inc Current Accepting new patients
Tampa Family Health Centers, Inc CurrentSince Jul 1, 2025 Accepting new patients
Tampa Family Health Centers, Inc. CurrentSince Jul 1, 2025 Accepting new patients

Locations

3513 Brighton Blvd
Ste 463
Denver, CO 80216

8880 Gladiolus Dr
Ste C200
Fort Myers, FL 33908
Phone (239) 533-5962

12085 W Hillsborough Ave
Tampa, FL 33635
Phone (813) 852-5270

2727 W Mlk Blvd
Ste 100A
Tampa, FL 33607

302 W Fletcher Ave
Tampa, FL 33612

4728 N Habana Ave
Ste 101B
Tampa, FL 33614
Phone (813) 775-9997

7814 N Dale Mabry Hwy
Tampa, FL 33614
Phone (813) 284-4554

910 Old Camp Rd
Ste 196
The Villages, FL 32162
Phone (352) 565-5553

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1083437651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 KINGS PALACE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335782131",
            "telephone_number": "813-724-8942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 KINGS PALACE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335782131",
            "telephone_number": "813-724-8942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "BROOKLYN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11034996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

Verify at the official NPI Registry.