MEDICARE: DR. PATRICK D BROOKS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	ME175961	FL
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1063975043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK D BROOKS MD

Provider Business Mailing Address
First Line	:	1577 ROBERTS DR STE 225
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32250-3265
Country	:	US
Telephone Number	:	904-241-1204
Fax Number	:	904-241-7331

Provider Business Practice Location Address
First Line	:	1577 ROBERTS DR STE 225
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32250-3265
Country	:	US
Telephone Number	:	904-241-1204
Fax Number	:	904-241-7331

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2019
Last Update Date	:	02/19/2026

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