Mark G Brooks M D P a
Organization Active NPI Internal Medicine Physician · Gotha, FL
NPI 1629066907 · NPPES record last updated Aug 31, 2026
Key facts
- NPI
- 1629066907
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- ME0070398 (FL)
- Legal business name
- MARK G BROOKS M D P A
- Practice address
- 3872 Old Winter Garden Rd
Suite 300 B
Gotha, FL 34734 - Phone
- (407) 578-6610
- Fax
- (407) 578-2247
- NPI assigned
- Oct 11, 2005
- Organization subpart
- No
Authorized official
- Name
- Ida Bonilla
- Title
- PA
- Phone
- (407) 578-6610
Practitioners 4
-
Mark G Brooks, M.D.
-
Terry Clemons, ARNP
-
Pedro Fabian Garcia, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040908000866 | FL | Part B Supplier - Clinic/Group Practice | 9537135827 |
Receives reassigned benefits from 3 practitioners Practice locations: Ocoee, FL |
National Provider Directory
Locations
3872 Old Winter Garden Rd
Ste 300
Gotha, FL 34734
Phone (407) 578-6610
10000 W Colonial Dr
Ste 180
Ocoee, FL 34761
Phone (407) 578-6610
10000 W Colonial Dr
Ste 187
Ocoee, FL 34761
Phone (407) 521-3500
10000 W Colonial Dr
Ste 484
Ocoee, FL 34761
Phone (407) 296-1933
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | ME0070398 | FL | Yes |
Addresses
Primary practice location
3872 Old Winter Garden Rd
Suite 300 B
Gotha, FL 34734
Mailing address
3872 Old Winter Garden Rd
Suite 300 B
Gotha, FL 34734
Phone (407) 578-6610
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110221576 | Other | FL | RAILROAD MEDICARE |
| 97989 | Other | FL | BCBS |
Other providers in Gotha, FL
- John C Fredrick
- Michelle Fredrick
- Gencare Therapy Inc.
- Home Therapy Partners, LLC
- Insyte Biomed LLC
- Darrell B McGee
- Clayton Alencar Moreira
- Nebula Medical LLC
- Orange Avenue Consulting
- Thais Pedrosa Ribeiro de Oliveira
All providers in Gotha, FL · Internal Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.