Provider Demographics
NPI:1467143859
Name:BROOKS, ZACHARY DAVID (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:DAVID
Last Name:BROOKS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 NE 164TH ST APT 640
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4291
Mailing Address - Country:US
Mailing Address - Phone:937-361-3975
Mailing Address - Fax:
Practice Address - Street 1:162 NE 25TH ST STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-4852
Practice Address - Country:US
Practice Address - Phone:305-735-8901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL44672225100000X
FL40200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist