Provider Demographics
NPI:1407100670
Name:BROOKS, ROSE JEANNIE (BC-FNP)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:JEANNIE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:BC-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2051
Mailing Address - Country:US
Mailing Address - Phone:205-420-2080
Mailing Address - Fax:
Practice Address - Street 1:1648 NE 163RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4731
Practice Address - Country:US
Practice Address - Phone:305-651-8770
Practice Address - Fax:305-651-7898
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9280333363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner