MEDICARE: DR. JAMES ODELL BROOKINS JR. M.D.

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	207R00000X	Internal Medicine Physician	ME46084	FL

General Provider Information

NPI Number	:	1265649370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES ODELL BROOKINS JR. M.D.

Provider Business Mailing Address
First Line	:	2815 W VIRGINIA AVE
Second Line	:	STE A
City	:	TAMPA
State	:	FL
Zip	:	33607-6357
Country	:	US
Telephone Number	:	813-876-0038
Fax Number	:	813-876-0103

Provider Business Practice Location Address
First Line	:	2815 W VIRGINIA AVE
Second Line	:	STE A
City	:	TAMPA
State	:	FL
Zip	:	33607-6357
Country	:	US
Telephone Number	:	813-876-0038
Fax Number	:	813-876-0103

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	07/08/2007

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