Brian Scott Brooks, PA
Physician Assistant in Hawthorne, FL. Individual provider (NPI-1).
NPI number1962401554
StatusActive
Last updated in NPPESFeb 25, 2020
Details
- NPI
- 1962401554
- Entity type
- Individual (NPI-1)
- Name
- Mr. Brian Scott Brooks
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 18, 2005
- Certification date
- Feb 25, 2020
- Last updated
- Feb 25, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA3061 | FL | Yes |
Practice location
22066 Se 71st AveHawthorne, FL 32640-3969
Phone 352-481-2700 · Fax 352-481-2392
Mailing address
1302 River StPalatka, FL 32177-5042
Phone 386-326-7342 · Fax 386-325-1086
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