Individual
DR. MICHAEL J BROOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1405 S ORANGE AVE, SECOND FLOOR, ORLANDO, FL 32806-2154
(407) 481-2244
(407) 481-8160
Mailing address
PO BOX 568008, ORLANDO, FL 32856-8008
(407) 481-2244
(407) 481-8160
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0052975
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047366900
—
FL
Enumeration date
11/29/2006
Last updated
04/17/2009
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