Provider Demographics
NPI:1821632779
Name:ROOKS, JOSHUA DANIEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DANIEL
Last Name:ROOKS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 MIAMI LAKEWAY S
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2747
Mailing Address - Country:US
Mailing Address - Phone:616-403-5958
Mailing Address - Fax:
Practice Address - Street 1:6520 MIAMI LAKEWAY S
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2747
Practice Address - Country:US
Practice Address - Phone:616-403-5958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10643103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist