MEDICARE: DR. DENNIS BRUCE MCBROOM JR. D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	PO 3283	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689865453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS BRUCE MCBROOM JR. D.P.M.

Provider Business Mailing Address
First Line	:	1890 LPGA BLVD STE 250
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-7131
Country	:	US
Telephone Number	:	386-339-4065
Fax Number	:

Provider Business Practice Location Address
First Line	:	1890 LPGA BLVD STE 250
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-7131
Country	:	US
Telephone Number	:	386-339-4065
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2007
Last Update Date	:	10/15/2024

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Directions to “ DR. DENNIS BRUCE MCBROOM JR. D.P.M.” Practice Location

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