Wilson Antoine Broussard Jr., MD

Primary specialty

Forensic Pathology PhysicianTaxonomy code 207ZF0201X

License

68954 Issued in FL

Practice address

4510 Fruitville Rd
Sarasota, FL 34232-1906

Phone

(941) 361-6909

Fax

(941) 361-6917

NPI assigned

May 9, 2026

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1778284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778284800000",
    "number": "1952239188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8547 GREAT MEADOW DR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342383309",
            "telephone_number": "941-730-0022",
            "fax_number": "941-361-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 FRUITVILLE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342321906",
            "telephone_number": "941-361-6909",
            "fax_number": "941-361-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "WILSON",
        "middle_name": "ANTOINE",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-05-09",
        "last_updated": "2026-05-09",
        "certification_date": "2026-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZF0201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Forensic Pathology",
            "state": "FL",
            "license": "68954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brookdale Senior Living Communities, Inc.
• Crystal Lynn Brooks, LCSW
• Meghan Ruth Brooks, OTA/L
• Phillip Jay Brooks, LMHC
• Brandon Kent Broom, CRNA
• Bailey Brown, DO
• Christina Lea Brown, O.D.
• David Philip Brown, PT
• Garrett Hunter Brown, M.D.
• Jackson Brown, MD

• Forensic Pathology Physician in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Forensic Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.