MEDICARE: DR. MAXIME DEBROSSE MD

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	208VP0000X	Pain Medicine Physician	ME135070	FL
2	208VP0014X	Interventional Pain Medicine Physician	ME135070	FL
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	ME135070	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	:	1750649703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAXIME DEBROSSE MD

Provider Business Mailing Address
First Line	:	3065 DANIELS RD # 1321
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-7002
Country	:	US
Telephone Number	:	689-208-4848
Fax Number	:	689-219-3746

Provider Business Practice Location Address
First Line	:	6909 OLD HIGHWAY 441 S STE 220
Second Line	:
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-7039
Country	:	US
Telephone Number	:	689-208-4848
Fax Number	:	689-219-3746

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

Provider Enumeration Date	:	04/27/2012
Last Update Date	:	03/23/2025

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Directions to “ DR. MAXIME DEBROSSE MD” Practice Location

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