Andrea Ann Brocker, PA-C
Individual provider Active NPI Physician Assistant · Ruskin, FL
NPI 1295601441 · NPPES record last updated Oct 15, 2025
Key facts
- NPI
- 1295601441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA9120757 (FL)
- Practice address
- 3873 Honolulu Dr
Ruskin, FL 33570-3682 - Phone
- (920) 650-3094
- NPI assigned
- Oct 15, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9120757 | FL | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9120757 | FL | Yes |
Addresses
Primary practice location
3873 Honolulu Dr
Ruskin, FL 33570-3682
Mailing address
3873 Honolulu Dr
Ruskin, FL 33570-3682
Phone (920) 650-3094
Other providers in Ruskin, FL
- Amanda Boodhoo
- Andria P Boyd-Diggs
- Ariel Nicole Bracey
- Reyna Q Bragg
- Alexandra M Brauner
- Brianna Brooks
- Markecha Brooks
- Abbigail Boyd Brown
- Ada L Brown
- Leila Brunner
All providers in Ruskin, FL · Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.