Provider Demographics
NPI:1134284177
Name:BROOKS, FRANCIS W (DO)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:W
Last Name:BROOKS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10379 STONE GLEN DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-8534
Mailing Address - Country:US
Mailing Address - Phone:407-721-9994
Mailing Address - Fax:407-249-5024
Practice Address - Street 1:3577 LAKE EMMA RD STE 109
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2000
Practice Address - Country:US
Practice Address - Phone:407-721-9994
Practice Address - Fax:407-249-5024
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS4539207Q00000X
FLOS004539208VP0000X, 204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS005230LOtherPA MEDICAL LICENSE
FLOS4539OtherFLORIDA MEDICAL LICENSE
PAOS005230LOtherPA MEDICAL LICENSE
FL82517ZMedicare ID - Type UnspecifiedMEDICARE