Healthcare Provider Details

I. General information

NPI: 1770087322
Provider Name (Legal Business Name): ZACHARY B BROOKS APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9961 W COLONIAL DR STE 108
OCOEE FL
34761-3428
US

IV. Provider business mailing address

9961 W COLONIAL DR STE 108
OCOEE FL
34761-3428
US

V. Phone/Fax

Practice location:
  • Phone: 407-347-0772
  • Fax:
Mailing address:
  • Phone: 407-347-0772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN9338531
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN9338531
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9338531
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: