Healthcare Provider Details

I. General information

NPI: 1093632515
Provider Name (Legal Business Name): JORDAN ADONIS BROOKS MD, JD, MPH, BA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 N BAYSHORE DR
MIAMI FL
33132-3203
US

IV. Provider business mailing address

1900 N BAYSHORE DRIVE 1A-155
MIAMI FL
33132
US

V. Phone/Fax

Practice location:
  • Phone: 740-504-7890
  • Fax:
Mailing address:
  • Phone: 740-504-7890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: