Individual
BROOKE S VERSCHAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
655 W 8TH ST, UFJAX - OTOLARYNGOLOGY, JACKSONVILLE, FL 32209-6511
(904) 244-4267
(904) 244-7730
Mailing address
PO BOX 44008, UFJP - PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3199
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY1414
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
468759749A
—
GA
05
—
6005349-00
—
FL
Enumeration date
06/15/2007
Last updated
05/21/2008
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