Active NPI
Stonebraker Medical, LLC
- Family Nurse Practitioner
- Fort Myers, FL
National Provider Identifier
1922892801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- STONEBRAKER MEDICAL, LLC
- Practice address
- 1922 Victoria Ave Ste a
Fort Myers, FL 33901-3441 - Phone
- (239) 699-1082
- Fax
- (239) 984-8873
- NPI assigned
- Apr 7, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Elizabeth Stonebraker, NP-C
- Title
- Family Nurse Practitioner
- Phone
- (239) 699-1082
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
1922 Victoria Ave Ste a
Fort Myers, FL 33901-3441
Mailing address
2034 SE 25TH Ter
Cape Coral, FL 33904-3238
Phone (304) 582-1990
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1922 Victoria Ave
Ste A
Fort Myers, FL 33901
Phone (239) 264-4318
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Fort Myers, FL
- NPI 1588195754
Family
-
- Nurse Practitioner
- Fort Myers, FL
- NPI 1477264000
-
- Family Nurse Practitioner
- Fort Myers, FL
- NPI 1780138008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743984000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1743984000000",
"number": "1922892801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2034 SE 25TH TER",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339043238",
"telephone_number": "304-582-1990",
"fax_number": "239-984-8873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1922 VICTORIA AVE STE A",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339013441",
"telephone_number": "239-699-1082",
"fax_number": "239-984-8873"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STONEBRAKER MEDICAL, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-04-07",
"last_updated": "2025-04-07",
"certification_date": "2025-04-07",
"status": "A",
"authorized_official_last_name": "STONEBRAKER",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "ELIZABETH",
"authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
"authorized_official_telephone_number": "239-699-1082",
"authorized_official_credential": "NP-C"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.