MEDICARE: STEVEN K BROOKS MD

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	208800000X	Urology Physician	ME59872	FL

General Provider Information

NPI Number	:	1992868228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN K BROOKS MD

Provider Business Mailing Address
First Line	:	515 W STATE ROAD 434
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32750-4981
Country	:	US
Telephone Number	:	407-841-5111
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 W STATE ROAD 434
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32750-5162
Country	:	US
Telephone Number	:	407-841-5111
Fax Number	:

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	07/19/2021

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