Provider Demographics
NPI:1356508428
Name:BROOKSHIRE, LAURA TERESA (DO)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:TERESA
Last Name:BROOKSHIRE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 SE MARICAMP ROAD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471
Mailing Address - Country:US
Mailing Address - Phone:352-369-8700
Mailing Address - Fax:352-698-8703
Practice Address - Street 1:2725 SE MARICAMP ROAD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-369-8700
Practice Address - Fax:352-698-8703
Is Sole Proprietor?:No
Enumeration Date:2008-05-17
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10380208000000X, 208D00000X, 208M00000X
MDH80972208000000X
FLOS20052208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS20052OtherMEDICAL LICENSE
FL002044000Medicaid