Brooks, Sandra L
Brooks, Sandra L is an individual health care provider with primary practice located at 533 N Nova Rd Ste 203 , Ormond Beach FL 32174-4422. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Brooks, Sandra L can be contacted via phone (386) 672-7175.Contact Information
Primary practice address
533 N Nova Rd Ste 203
Ormond Beach FL 32174-4422
Phone: (386) 672-7175
Fax: (386) 672-0771
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 2650922 | Florida |
Profile Details
NPI number | 1790783207 |
---|---|
LBN Legal business name | Brooks, Sandra L |
Credentials | ARNP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 8th, 2005 |
Last updated | Dec 22nd, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1790783207 | NPPES |
Florida | MEDICAID | 305058100 | |
Florida | Other | 1790783207 |
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