Individual
DR. BRIAN W COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3599 UNIVERSITY BLVD S, BLDG. 500, STE. 504, JACKSONVILLE, FL 32216-4252
(904) 398-5614
(904) 398-5617
Mailing address
3599 UNIVERSITY BLVD S, BLDG. 500, STE. 504, JACKSONVILLE, FL 32216-4252
(904) 398-5614
(904) 398-5617
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME114000
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001229087
MEDICARE ID
FL
Enumeration date
07/27/2006
Last updated
04/16/2014
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