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Organization
CARILLON SPORTS AND FAMILY MEDICINE PA
Active
Organization
CARILLON SPORTS AND FAMILY MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM A BRUNSON MD (PRESIDENT)
(727) 561-4303
Entity
Organization
Contact information
Practice address
12225 28TH ST N, SUITE B, ST PETERSBURG, FL 33716-1860
(727) 561-4303
(727) 561-9299
Mailing address
12225 28TH ST N, SUITE B, ST PETERSBURG, FL 33716-1860
(727) 561-4303
(727) 561-9299
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
ME80751
FL
Other
Enumeration date
06/27/2007
Last updated
05/12/2011
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