DR. JOHN BROUSSARD (NPI# 1174839161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174839161 |
| Entity Type | Individual |
| Full Name | DR. JOHN BROUSSARD |
| Credential | DO |
| Practice Address |
111 2nd Ave Ne Ste 1401 St Petersburg FL 33701-3480 |
| Practice Telephone | 7272587224 |
| Mailing Telephone | 7272587224 |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2020-08-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
OS12241 | FL | Allopathic & Osteopathic Physicians |
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
0102204383 | VA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013271196 | John Robert Broussard | Counselor | 2711 Edgewood Dr, Placerville, CA 95667-3409 | 2012-07-03 |
| 1750696639 | John Edward Broussard | Pharmacist | 105 Cities Service Hwy, Sulphur, LA 70663-5419 | 2010-08-16 |
| 1326509977 | John Broussard | Student in an Organized Health Care Education/Training Program | 1430 Tulane Ave # 8679, New Orleans, LA 70112-2632 | 2019-03-27 |
| 1033645494 | John Joseph Broussard | Physical Therapist | 2115 Dulles Dr, Lafayette, LA 70506-2652 | 2017-05-04 |
| 1063648889 | John Broussard | Physical Therapist | 620 N Morrison Blvd Ste G, Hammond, LA 70401-2312 | 2009-06-08 |
| 1548462898 | John Broussard | Physical Therapist | 4412 N Davis Hwy, Pensacola, FL 32503-2756 | 2007-05-31 |
| 1992844476 | John King Broussard | Psychologist | 1600 Airport Fwy, Suite 322, Bedford, TX 76022-6850 | 2007-02-05 |
| Street Address |
111 2ND AVE NE STE 1401 |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33701-3480 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514603 | Tien Thuy Hoang | Pharmacist | 875 Dr M.l.k. Jr St N, St. Petersburg, FL 33701 | 2020-10-06 |
| 1851920953 | Michelle Tedrowe | Student in an Organized Health Care Education/Training Program | Bayfront Health St Petersburg Family Care Center, 700 6th Street South, St. Petersburg, FL 33701 | 2020-04-02 |
| 1164070264 | Melissa Joy Fitzpatrick | Occupational Therapist | 239 14 Ave Ne, St Petersburg, FL 33701 | 2019-09-01 |
| 1841763091 | William Carpenter Scott | Dentist | 239 2nd Ave S # 100, St Petersburg, FL 33701 | 2019-01-09 |
| 1992289318 | Westminster Senior Services, Inc. | Registered Nurse | 830 North Shore Dr. Ne, St. Petersburg, FL 33701 | 2018-09-21 |
| 1265929780 | B&b Florida Eye Care Pllc | Optometrist | 1380 4th St N, St. Petersburg, FL 33701 | 2018-04-19 |
| 1730684895 | Loraine Marie Torres Garcia | Student in an Organized Health Care Education/Training Program | Bayfront Health St Petersburg, 700 6th Street South, St Petersburg, FL 33701 | 2018-03-29 |
| 1598267445 | Vincent Malik Dehili | Psychologist | 146 2nd Street North, Suite 305, St. Petersburg, FL 33701 | 2018-03-07 |
| 1770083073 | Megan Sanborn | Nurse Practitioner | 601 5th St S Ste 304, St Petersburg, FL 33701 | 2018-02-14 |
| 1174037089 | Julius Griffin | Licensed Practical Nurse | 1115 Highland St N, Apt B, Saint Petersburg, FL 33701 | 2017-11-30 |
| Find all providers in zip 33701 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235398058 | St Anthony's Primary Care LLC | Family Medicine | 116 1st St N, St Petersburg, FL 33701-3305 | 2008-06-06 |
| 1225451180 | Team Physicians, LLC | Family Medicine | 4200 54th Ave S, St Petersburg, FL 33711-4744 | 2014-01-29 |
| 1619216249 | Arnold M. Ramirez | Family Medicine | 4200 54th Ave S, St Petersburg, FL 33711-4744 | 2013-02-01 |
| 1275730970 | Carillon Sports and Family Medicine Pa | Family Medicine | 12225 28th St N, Suite B, St Petersburg, FL 33716-1860 | 2007-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720607484 | Black Stallion Walk-in and Exercise Medicine Clinics LLC | Family Medicine | 9955 Se Federal Hwy, Hobe Sound, FL 33455-4829 | 2020-04-13 |
| 1003371519 | Affordable Medical Clinic of Wellii | Family Medicine | 12773 Forest Hill Blvd Ste 1203, Wellington, FL 33414-4760 | 2019-02-08 |
| 1609391929 | Baptist Physician Group LLC | Family Medicine | 8880 Navarre Pkwy Ste 206, Navarre, FL 32566-3614 | 2017-08-08 |
| 1568997880 | Sports Medicine and Rehab Fitness | Family Medicine | 4405 Crooked Mile Rd, Merritt Island, FL 32952-6310 | 2017-04-24 |
| 1770037822 | Daniel Gonzalez | Family Medicine | 11050 Griffin Rd, Davie, FL 33328-3226 | 2016-08-06 |
| 1497174478 | John Sami Maarouf | Family Medicine | 301 Harbour Place Dr Unit 2007, Tampa, FL 33602-6808 | 2014-04-07 |
| 1487091393 | Michelle Henne | Family Medicine | 5535 Cypress Gardens Blvd Ste 270, Winter Haven, FL 33884-2241 | 2013-05-31 |
| 1053678151 | Jonathan Paul Bonnet | Family Medicine | 4830 Nw 43rd St, M194, Gainesville, FL 32606-4401 | 2012-04-13 |
| 1891092862 | Ozaki, Inc. | Family Medicine | 1600 S Ocean Dr Apt 17d, Hollywood, FL 33019-2427 | 2011-02-28 |
| 1588980346 | Sonia Isabel Millan Pinzon | Family Medicine | 120 Cypress Edge Dr Ste 207, Palm Coast, FL 32164-8454 | 2010-04-19 |
| Find all providers with the same taxonomy | ||||
| City | ST PETERSBURG |
| Zip Code | 33701 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.