Provider Demographics
NPI:1770087322
Name:BROOKS, ZACHARY BLAIR (ARNP-C)
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:BLAIR
Last Name:BROOKS
Suffix:
Gender:M
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10000 W COLONIAL DR STE 389
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3433
Mailing Address - Country:US
Mailing Address - Phone:407-822-1171
Mailing Address - Fax:407-822-1172
Practice Address - Street 1:10000 W COLONIAL DR STE 389
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3433
Practice Address - Country:US
Practice Address - Phone:407-822-1171
Practice Address - Fax:407-822-1172
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9338531363L00000X
FLAPRN9338531363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology