ALLIANCE REGENERATIVE AND PERFORMANCE MEDICINE, PLLC
NPI 1104418292
Family Medicine - Sports Medicine in St Petersburg, FL

Active since February 09, 2021
111 2ND AVE NE STE 1401, ST PETERSBURG, FL 33701(727) 258-7224 Get Directions Write a Review

NPPES record last updated: February 9, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Family Medicine
  • Sports Medicine

About ALLIANCE REGENERATIVE AND PERFORMANCE MEDICINE, PLLC

This page provides the complete NPI Profile along with additional information for Alliance Regenerative And Performance Medicine, Pllc, a primary care provider established in St Petersburg, Florida operating as a Family Medicine, focusing in sports medicine . The healthcare provider is registered in the NPI registry with number 1104418292 assigned on February 2021. The practitioner's primary taxonomy code is 207QS0010X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. John Broussard Do (Owner)

NPI
1104418292 Verify this NPI
Provider Name
ALLIANCE REGENERATIVE AND PERFORMANCE MEDICINE, PLLC
Entity Type
Organization
Location Address
111 2ND AVE NE STE 1401 ST PETERSBURG, FL 33701
Location Phone
(727) 258-7224
Mailing Address
111 2ND AVE NE STE 1401 ST PETERSBURG, FL 33701
Mailing Phone
(727) 258-7224
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-09-2021
Last Update Date
02-09-2021
Code Navigator

A primary care provider (PCP) like Alliance Regenerative And Performance Medicine, Pllc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine Sports Medicine

Taxonomy Code
207QS0010X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. JOHN BROUSSARD DO

Authorized Official Title
OWNER
Authorized Official Phone
(727) 258-7224

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Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Family Medicine (Sports Medicine)
111 2ND AVE NE STE 1401
ST PETERSBURG, FL 33701
Physical Therapist (Sports)
111 2ND AVE NE STE 1401
ST PETERSBURG, FL 33701
Physical Therapist (Sports)
111 2ND AVE NE STE 1401
ST PETERSBURG, FL 33701
Physical Therapist
111 2ND AVE NE STE 1401
ST PETERSBURG, FL 33701

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104418292, enumerated as an "organization" on February 09, 2021.

The provider is located at 111 2ND AVE NE STE 1401 ST PETERSBURG, FL 33701 and the phone number is (727) 258-7224.

Family Medicine with taxonomy code 207QS0010X and a focus in Sports Medicine.