Healthcare Provider Details

I. General information

NPI: 1013348424
Provider Name (Legal Business Name): BROOKS REHABILITATION CLINICAL RESEARCH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 UNIVERSITY BLVD S
JACKSONVILLE FL
32216-4312
US

IV. Provider business mailing address

3599 UNIVERSITY BLVD S MANAGED CARE
JACKSONVILLE FL
32216-4252
US

V. Phone/Fax

Practice location:
  • Phone: 904-345-8973
  • Fax: 904-342-7284
Mailing address:
  • Phone: 904-345-7607
  • Fax: 904-345-7284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENI ALLEN
Title or Position: DIRECTOR OF MANAGED CARE
Credential:
Phone: 904-345-7158