Provider Demographics
NPI:1609590942
Name:BROOKS, JOHN J JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:BROOKS
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 N 4TH ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-3733
Mailing Address - Country:US
Mailing Address - Phone:229-289-7168
Mailing Address - Fax:
Practice Address - Street 1:209 N 4TH ST UNIT 2
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3733
Practice Address - Country:US
Practice Address - Phone:229-289-7168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL64903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist