Organization
LARRY BROOKS, PH.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE FLORES (ACCOUNTS SPECIALIST)
(754) 201-2265
Entity
Organization
Contact information
Practice address
80 SW 8TH ST STE 2185, MIAMI, FL 33130-3004
(786) 303-1991
Mailing address
3810 HOLLYWOOD BLVD STE 2, HOLLYWOOD, FL 33021-6779
(786) 303-1991
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PY8127
FL
103T00000X
Psychologist
Primary
PY8127
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY8127
DOH
FL
Enumeration date
11/20/2012
Last updated
11/20/2012
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