Natalya    Bulaeva    MD
Contract Details
Brooks Rehabilitation Medical Group
Facility name
Provider ID
P000000001
NPI
1790743342
Tax ID
593530305
Effective Date
2/13/2020
Last Updated
7/15/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_441
Location Details
Address
3901 University Blvd South Suite 103
Jacksonville, FL 32216
United States
Phone
904-345-7373 (Phone)
Billing Details
Address
3901 University Blvd South
Suite 103
Jacksonville, FL 32216
Billing Phone
904-345-7373
Specialty Type
Physical Medicine & Rehabilitation
Map
Address