Broutin, Dominique
Broutin, Dominique is an sole proprietor health care provider with primary practice located at 3113 Lawton Rd Ste 100 , Orlando FL 32803-3519. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, Ambulatory Health Care Facilities / Student Health. Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism is her primary health care specialty. Broutin, Dominique can be contacted via phone (407) 894-3241.Contact Information
Primary practice address
3113 Lawton Rd Ste 100
Orlando FL 32803-3519
Phone: (407) 894-3241
Fax: (407) 896-9863
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism | 207RE0101X | ME163046 | Florida |
| Ambulatory Health Care Facilities / Student Health | 261QS1000X |
Profile Details
| NPI number | 1194228924 |
|---|---|
| LBN Legal business name | Broutin, Dominique |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 18th, 2018 |
| Last updated | Jul 19th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194228924 | NPPES |
| Florida | MEDICAID | 118632800 |
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