Individual
DR. BRANDON EDWARD DEROUCHIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
17751 MURDOCK CIR, PORT CHARLOTTE, FL 33948-1034
(941) 743-8700
(941) 743-8850
Mailing address
25241 ELEMENTARY WAY STE 200, BONITA SPRINGS, FL 34135-7883
(239) 947-4184
(239) 947-4171
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
049257-01
NY
225100000X
Physical Therapist
Primary
P23351
NC
225100000X
Physical Therapist
PT41183
FL
Other
Enumeration date
08/29/2022
Last updated
08/05/2024
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