Provider Demographics
NPI:1265649370
Name:BROOKINS, JAMES ODELL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ODELL
Last Name:BROOKINS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2815 W VIRGINIA AVE
Mailing Address - Street 2:STE A
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6357
Mailing Address - Country:US
Mailing Address - Phone:813-876-0038
Mailing Address - Fax:813-876-0103
Practice Address - Street 1:2815 W VIRGINIA AVE
Practice Address - Street 2:STE A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6357
Practice Address - Country:US
Practice Address - Phone:813-876-0038
Practice Address - Fax:813-876-0103
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
FLME46084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD62221Medicare UPIN