Provider Demographics
NPI:1881254142
Name:BROOKS, DARRIN SCOTT (PTA)
Entity type:Individual
Prefix:MR
First Name:DARRIN
Middle Name:SCOTT
Last Name:BROOKS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23159 AMGCI WAY UNIT 306
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-2593
Mailing Address - Country:US
Mailing Address - Phone:239-398-7145
Mailing Address - Fax:
Practice Address - Street 1:10949 PARNU ST
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-1405
Practice Address - Country:US
Practice Address - Phone:239-592-5501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA1613225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant