Provider Demographics
NPI:1639119597
Name:COOKS, AARON LAMAR (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:LAMAR
Last Name:COOKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3628 MADISON CYPRESS DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-4202
Mailing Address - Country:US
Mailing Address - Phone:813-789-4729
Mailing Address - Fax:
Practice Address - Street 1:3628 MADISON CYPRESS DR
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-4202
Practice Address - Country:US
Practice Address - Phone:813-789-4729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88784207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273379000Medicaid
FLU5539ZMedicare PIN