Organization
ALLIANCE REGENERATIVE AND PERFORMANCE MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN BROUSSARD DO (OWNER)
(727) 258-7224
Entity
Organization
Contact information
Practice address
111 2ND AVE NE STE 1401, ST PETERSBURG, FL 33701-3480
(727) 258-7224
Mailing address
111 2ND AVE NE STE 1401, ST PETERSBURG, FL 33701-3480
(727) 258-7224
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
02/09/2021
Last updated
02/09/2021
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