Provider Demographics
NPI:1639244353
Name:BROOKS, ANDRE M (MD)
Entity Type:Individual
Prefix:MR
First Name:ANDRE
Middle Name:M
Last Name:BROOKS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10091 CORTEZ BLVD
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-6378
Mailing Address - Country:US
Mailing Address - Phone:352-597-4631
Mailing Address - Fax:352-597-0076
Practice Address - Street 1:10145 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:WEEKI WACHEE
Practice Address - State:FL
Practice Address - Zip Code:34613-6385
Practice Address - Country:US
Practice Address - Phone:352-597-4631
Practice Address - Fax:352-597-0076
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2024-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME9444207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL054647000Medicaid
FLB35605Medicare UPIN
FL054647000Medicaid
FL060015564Medicare PIN
FL12560XMedicare PIN