Provider Demographics
NPI:1497754303
Name:BRUTUS, ROLAND (MD)
Entity Type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:
Last Name:BRUTUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 WEST COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818
Mailing Address - Country:US
Mailing Address - Phone:321-960-8209
Mailing Address - Fax:
Practice Address - Street 1:1800 PEMBROOK DR STE 300
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-6378
Practice Address - Country:US
Practice Address - Phone:321-200-4489
Practice Address - Fax:407-554-5860
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD05924207L00000X
FLME83974207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7000246Medicaid
RI7000246Medicaid