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Organization
HERBERT E BROOKS MD PA
Active
Organization
HERBERT E BROOKS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERBERT EDWIN BROOKS MD (OWNER)
(850) 547-4793
Entity
Organization
Contact information
Practice address
2126 HIGHWAY 173, BONIFAY, FL 32425-5704
(850) 547-4556
(850) 547-4511
Mailing address
PO BOX 699, BONIFAY, FL 32425-0699
(850) 547-4556
(850) 547-4511
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
ME11075
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043250400
—
FL
01
—
30009
BCBS
FL
01
—
ME0011075
WC
FL
Enumeration date
11/02/2009
Last updated
01/08/2010
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