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Individual

BRIAN W COOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2560 N MCMULLEN BOOTH RD, STE B, CLEARWATER, FL 33761-4182
(727) 726-1962
Mailing address
PO BOX 17308, CLEARWATER, FL 33762-0308
(904) 482-1070
(904) 482-1077

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME0083573
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06039
BLUE SHIELD OF FL
FL
05
264873300
FL
Enumeration date
06/12/2006
Last updated
03/11/2011
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