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Individual

MR. BRIAN SCOTT BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
22066 SE 71ST AVE, HAWTHORNE, FL 32640-3969
(352) 481-2700
(352) 481-2392
Mailing address
1302 RIVER ST, PALATKA, FL 32177-5042
(386) 326-7342
(386) 325-1086

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3061
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
290204400
FL
Enumeration date
07/18/2005
Last updated
02/25/2020
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