MEDICARE: DR. MARK STEVEN BROMSON M.D.

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	174400000X	Specialist	ME65743	FL
2	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	ME65743	FL
3	207X00000X	Orthopaedic Surgery Physician	ME65743	FL

General Provider Information

NPI Number	:	1942319538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK STEVEN BROMSON M.D.

Provider Business Mailing Address
First Line	:	660 GLADES RD
Second Line	:	SUITE 460
City	:	BOCA RATON
State	:	FL
Zip	:	33431-6465
Country	:	US
Telephone Number	:	561-391-5515
Fax Number	:	561-347-7470

Provider Business Practice Location Address
First Line	:	660 GLADES RD STE 460
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33431-6469
Country	:	US
Telephone Number	:	561-391-5515
Fax Number	:	561-347-7470

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	02/27/2022

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