Healthcare Provider Details

I. General information

NPI: 1821072315
Provider Name (Legal Business Name): JAMES L BROOKS L.AC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 11/08/2021
Certification Date: 11/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 NW 57TH ST STE A
GAINESVILLE FL
32605-6425
US

IV. Provider business mailing address

912 NW 57TH ST STE A
GAINESVILLE FL
32605-6425
US

V. Phone/Fax

Practice location:
  • Phone: 352-226-4433
  • Fax:
Mailing address:
  • Phone: 352-226-4433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP2916
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: