Active NPI
Gerard Thomas Brooker
- Athletic Trainer
- Coral Gables, FL
National Provider Identifier
1104573104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL6105
- Practice address
- 5555 Ponce de Leon Blvd
Coral Gables, FL 33146-2513 - Phone
- (305) 689-5555
- NPI assigned
- Mar 9, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL6105 | FL | Primary |
Addresses
Primary practice location
5555 Ponce de Leon Blvd
Coral Gables, FL 33146-2513
Mailing address
4541 Emerald Vis Apt F245
Lake Worth, FL 33461-7239
Phone (434) 944-7413
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL6105 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646784000000",
"number": "1104573104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4541 EMERALD VIS APT F245",
"city": "LAKE WORTH",
"state": "FL",
"postal_code": "334617239",
"telephone_number": "434-944-7413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 PONCE DE LEON BLVD",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "331462513",
"telephone_number": "305-689-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKER",
"first_name": "GERARD",
"middle_name": "THOMAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-09",
"last_updated": "2022-03-09",
"certification_date": "2022-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL6105",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coral Gables, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.