Individual
DR. TONIA BROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
820 PRUDENTIAL DR STE 713, EMERGENCY RESOURCES GROUP, JACKSONVILLE, FL 32207-8209
(904) 396-5682
(904) 346-0864
Mailing address
PO BOX 863640, ORLANDO, FL 32886-3640
(904) 396-5682
(904) 346-0864
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
OS9193
FL
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
OS9193
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269469700
—
FL
01
—
37967
BCBS
FL
01
—
690157811B
GA MEDICAID
GA
Enumeration date
04/27/2006
Last updated
08/28/2024
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