Provider Demographics
NPI:1750649703
Name:DEBROSSE, MAXIME (MD)
Entity Type:Individual
Prefix:DR
First Name:MAXIME
Middle Name:
Last Name:DEBROSSE
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 1:3065 DANIELS RD # 1321
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-7002
Mailing Address - Country:US
Mailing Address - Phone:689-208-4848
Mailing Address - Fax:689-219-3746
Practice Address - Street 1:6909 OLD HIGHWAY 441 S STE 220
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-7039
Practice Address - Country:US
Practice Address - Phone:689-208-4848
Practice Address - Fax:689-219-3746
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME135070208VP0014X, 208VP0000X, 207LP2900X, 208VP0014X, 208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine