Healthcare Provider Details

I. General information

NPI: 1558817841
Provider Name (Legal Business Name): ROBIN BROOKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 08/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6299 W SUNRISE BLVD SUITE 211C
PLANTATION FL
33313-6180
US

IV. Provider business mailing address

6229 W SUNRISE BLVD SUITE 211C
SUNRISE FL
33313-0000
US

V. Phone/Fax

Practice location:
  • Phone: 954-643-6443
  • Fax: 954-578-2165
Mailing address:
  • Phone: 954-643-6443
  • Fax: 954-578-2165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number210676
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number234401
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number234401
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number234401
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number234401
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number23
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: