Individual
DEIDRA BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14280 WALSINGHAM RD, LARGO, FL 33774-3231
(727) 596-2101
Mailing address
14280 WALSINGHAM RD, LARGO, FL 33774-3231
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
27995
MD
225100000X
Physical Therapist
34389
FL
Other
Enumeration date
03/01/2019
Last updated
05/11/2021
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