BRIAN PAUL BROUSSARD (NPI# 1750809448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750809448 |
Entity Type | Individual |
Full Name | BRIAN PAUL BROUSSARD |
Credential | DPT |
Practice Address |
15049 Bruce B Downs Blvd Tampa FL 33647-1388 |
Mailing Address |
2301 Stirling Cir Unit 206 Dunedin FL 34698-7055 |
Practice Telephone | 8135637668 |
Mailing Telephone | 3372540880 |
Enumeration Date | 2017-09-02 |
Last Update Date | 2018-10-24 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2251S0007X |
Physical Therapist Specialization: Sports |
PT34062 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
N | 2251S0007X |
Physical Therapist Specialization: Sports |
1679719421 | VA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
2751 Prosperity Ave, Fairfax, VA 220314397 | 7032373930 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114037314 | Brian J Broussard | Nurse Anesthetist, Certified Registered | 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508-6917 | 2006-08-30 |
Street Address |
15049 BRUCE B DOWNS BLVD |
City | TAMPA |
State | FL |
Zip Code | 33647-1388 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962854802 | Root Cause Medical Clinic LLC | General Practice | 15049 Bruce B Downs Blvd, Tampa, FL 33647-1388 | 2016-07-04 |
1992351100 | Lauren Ashleigh Leiva | Physical Therapist | 15049 Bruce B Downs Blvd, Tampa, FL 33647-1388 | 2019-08-13 |
1184174179 | The Root Cause Clinic | Clinic/Center | 15049 Bruce B Downs Blvd, Tampa, FL 33647-1388 | 2016-10-13 |
1366998304 | Derek D Stewart | Chiropractor | 15049 Bruce B Downs Blvd, Tampa, FL 33647-1388 | 2016-08-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558972935 | Innovative Healthcare of Florida, Inc. | Home Health | 8903 Bruce B Downs Blvd, Tampa, FL 33647 | 2020-08-11 |
1093331498 | Envision In-home Companion Svcs | Home Health | 8903 Bruce B. Downs Blvd, Suite #140, Tampa, FL 33647 | 2020-06-22 |
1538788344 | Deanna Rene Shelpman | Massage Therapist | 15443 Plantation Oaks Dr, Apt 13, Tampa, FL 33647 | 2020-04-11 |
1316598998 | Paramount Health Group LLC | In Home Supportive Care | 17425 Bridge Hill Crt. Unit 200b, Tampa, FL 33647 | 2019-09-24 |
1174185656 | S&k Management Services | Clinical Nurse Specialist | 19046 Bruce B. Downs Blvd, Ste 177, Tampa, FL 33647 | 2019-07-03 |
1760040133 | Calisia Sapp | Clinic/Center | 19046 Bruce B Downs Blvd Ste B6-703, Tampa, FL 33647 | 2019-05-31 |
1306400106 | B2b Apps Solutions, LLC | Durable Medical Equipment & Medical Supplies | 17931 Cachet Isle Drive, Tampa, FL 33647 | 2019-04-26 |
1376000919 | Florida Homecare Specialists Minority Corp | Home Health | 5331 Primrose Lake Circle Unit 116, Tampa, FL 33647 | 2019-03-01 |
1982188157 | Dynamic Support Solutions, LLC | Home Health | 8606 Baneberry Ct, Tampa, FL 33647 | 2018-09-24 |
1982197430 | Erika Mendoza-hutto | Nurse Practitioner | 20713 Center Oak Dr, Tampa, FL 33647 | 2018-06-10 |
Find all providers in zip 33647 |
Taxonomy Code | 2251S0007X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Physical Therapist |
Specialization | Sports |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194209205 | Jack Malafronte | Physical Therapist | 2221 S Dale Mabry Hwy, Tampa, FL 33629-6313 | 2018-09-25 |
1134643356 | Thomas Mulligan | Physical Therapist | 401 Channelside Dr, Tampa, FL 33602-5400 | 2017-07-29 |
1508348640 | James Francis Haughney IIi | Physical Therapist | 4539 S Dale Mabry Hwy Ste 110, Tampa, FL 33611-1404 | 2018-09-05 |
1144293408 | Jody Carl Andersen | Physical Therapist | 401 W Kennedy Blvd, Box 30f, Tampa, FL 33606-1450 | 2006-02-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538721907 | Revolution Sports and Performance LLC | Physical Therapist | 27774 Autumn Breeze Cir, Wesley Chapel, FL 33544-7839 | 2019-07-05 |
1790242105 | Ignacio Ray Barajas | Physical Therapist | 11723 Gulf Beach Hwy, Pensacola, FL 32507-9143 | 2019-02-22 |
1679041081 | Mauricio Elizondo | Physical Therapist | 201 Atp Tour Blvd, Ponte Vedra Beach, FL 32082-3211 | 2018-11-05 |
1881109791 | Michael R Preciados | Physical Therapist | 2999 Ne 191st St Ste 230, Aventura, FL 33180-3115 | 2017-12-14 |
1467970277 | Naples Premier Physical Therapy Inc | Physical Therapist | 3940 Prospect Ave Ste 103, Naples, FL 34104-3745 | 2017-08-31 |
1962952333 | Jordan Clayborne | Physical Therapist | 4747 N Ocean Dr Ste 261, Lauderdale By The Sea, FL 33308-2956 | 2016-10-10 |
1043764483 | Tonny Vandehee | Physical Therapist | 3264 Pacific Dr, Naples, FL 34119-8672 | 2016-08-14 |
1861848517 | Physioworks of Miami | Physical Therapist | 3617 E Sandpiper Dr, #5, Boynton Beach, FL 33436-2463 | 2016-05-12 |
1538433552 | Physical Therapy & Sports Rehab LLC | Physical Therapist | 1290 Old Congress Ave., West Palm Beach, FL 33409 | 2012-03-08 |
1881829240 | Jeremy M Martin | Physical Therapist | 4767 Drane Field Rd, Lakeland, FL 33811-1220 | 2009-05-28 |
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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.