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Individual

DOMINIQUE BROUTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3113 LAWTON RD STE 100, ORLANDO, FL 32803-3519
(407) 894-3241
(407) 896-9863
Mailing address
3113 LAWTON RD STE 100, ORLANDO, FL 32803-3519
(407) 894-3241
(407) 896-9863

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
ME163046
FL
261QS1000X
Student Health Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
118632800
FL
Enumeration date
03/18/2018
Last updated
07/19/2023
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