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NPI Code Detail

MEDICARE: BROOKE ALLISON VALLAS

MEDICARE: BROOKE ALLISON VALLAS
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
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1275421026
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE ALLISON VALLAS
Provider Business Mailing Address
First Line : PO BOX 543
Second Line :
City : HOLLISTER
State : FL
Zip : 32147-0543
Country : US
Telephone Number : 386-336-3128
Fax Number :
Provider Business Practice Location Address
First Line : 3253 SW 121ST WAY
Second Line :
City : GAINESVILLE
State : FL
Zip : 32608-0225
Country : US
Telephone Number : 727-457-0101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2025
Last Update Date : 06/27/2025

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Directions to “ BROOKE ALLISON VALLAS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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