Individual
MS. BLONDELL BROOKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
919 E 2ND ST, SANFORD, FL 32771-2101
(407) 875-3700
(407) 735-1632
Mailing address
5151 ADANSON ST, ORLANDO, FL 32804-1317
(407) 875-3700
(407) 735-1632
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
751026800
MEDICAID
—
05
—
751026800
—
FL
Enumeration date
01/30/2007
Last updated
03/06/2024
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