MEDICARE: ROZINA E BROOKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372600000X	Adult Companion
2	376J00000X	Homemaker	234523	FL

General Provider Information

NPI Number	:	1366926479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROZINA E BROOKS

Provider Business Mailing Address
First Line	:	905 NE 1ST ST
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-4401
Country	:	US
Telephone Number	:	352-601-8743
Fax Number	:	352-794-3871

Provider Business Practice Location Address
First Line	:	7449 W GULF TO LAKE HWY
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-7835
Country	:	US
Telephone Number	:	352-601-8743
Fax Number	:	352-794-3871

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2018
Last Update Date	:	09/24/2018

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Directions to “ ROZINA E BROOKS ” Practice Location

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