NPIMap

Organization Active NPI

Brooks Management

  • Dermatology Physician
  • Bradenton, FL
National Provider Identifier
1093017774
Registry record updated Dec 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME44267 Issued in FL
Legal business name
BROOKS MANAGEMENT
Practice address
2919 26TH St W
Bradenton, FL 34205-3737
Phone
(941) 755-2255
Fax
(941) 756-4465
NPI assigned
Dec 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jack C Jawitz, M.D.NPI 1316934714
Title
President
Phone
(941) 755-2255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X ME44267 FL Primary

Addresses

Primary practice location

2919 26TH St W
Bradenton, FL 34205-3737

Mailing address

2919 26TH St W
Bradenton, FL 34205-3737
Phone (941) 755-2255

Other identifiers 1

IdentifierTypeStateIssuer
068779100MedicaidFL

National Provider Directory

National Provider Directory

Locations

2919 26th St W
Bradenton, FL 34205
Phone (941) 755-2255

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291161600000",
    "number": "1093017774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 26TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342053737",
            "telephone_number": "941-755-2255",
            "fax_number": "941-756-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 26TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342053737",
            "telephone_number": "941-755-2255",
            "fax_number": "941-756-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKS MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-01",
        "last_updated": "2010-12-01",
        "status": "A",
        "authorized_official_last_name": "JAWITZ",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-755-2255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME44267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068779100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.