Provider Demographics
NPI:1366926479
Name:BROOKS, ROZINA E
Entity type:Individual
Prefix:
First Name:ROZINA
Middle Name:E
Last Name:BROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 NE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429-4401
Mailing Address - Country:US
Mailing Address - Phone:352-601-8743
Mailing Address - Fax:352-794-3871
Practice Address - Street 1:7449 W GULF TO LAKE HWY
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-7835
Practice Address - Country:US
Practice Address - Phone:352-601-8743
Practice Address - Fax:352-794-3871
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X
FL234523376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion