Provider Demographics
NPI:1851725311
Name:BROOKS, CHARLES A (ARNP)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:A
Last Name:BROOKS
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 NE 120TH PL
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34479-1064
Mailing Address - Country:US
Mailing Address - Phone:352-427-9087
Mailing Address - Fax:
Practice Address - Street 1:6160 SW HIGHWAY 200 STE 119
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-8307
Practice Address - Country:US
Practice Address - Phone:352-694-6331
Practice Address - Fax:352-694-6338
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-02
Last Update Date:2013-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9249981363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily