Individual
DR. MARK BRODEUR
Active
Individual
DR. MARK BRODEUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
ME0090285
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
269864100
FLORIDA MEDICAID
FL
05
—
269864100
—
FL
01
—
44098
BCBS
FL
05
—
787365756A
—
GA
01
—
P00139639
RRMCR
FL
01
—
P00139639
RAILROAD MEDICARE
—
Enumeration date
01/04/2006
Last updated
07/30/2008
Update your record
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