Brooke N Mavroides, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9117191 Issued in FL

Practice address

510 N Parrott Ave
Okeechobee, FL 34972-2645

Phone

(863) 824-3480

Fax

(863) 824-0588

NPI assigned

Mar 9, 2023

Last updated

May 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Brooke N Snyder Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1407556244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 N PARROTT AVE",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349722645",
            "telephone_number": "863-824-3480",
            "fax_number": "863-824-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N PARROTT AVE",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349722645",
            "telephone_number": "863-824-3480",
            "fax_number": "863-824-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVROIDES",
        "first_name": "BROOKE",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9117191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "SNYDER",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Medical Physician Assistant in Okeechobee, FL
• Providers in Okeechobee, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.