Individual
BROOKE N MARYAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME107656
FL
207LP3000X
Pediatric Anesthesiology Physician
ME107656
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009253400
—
FL
Enumeration date
04/24/2009
Last updated
05/11/2021
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