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BRIAN PAUL BROUSSARD DPT
NPI 1750809448
Physical Therapist - Sports in St Petersburg, FL

Active since September 02, 2017
111 2ND AVE NE STE 1401, ST PETERSBURG, FL 33701(727) 258-7224 Get Directions Write a Review

NPPES record last updated: June 9, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 9, 2021, Oct 24, 2018, Sep 2, 2017 (3 updates tracked since 2017).

About Brian Paul Broussard Dpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRIAN PAUL BROUSSARD DPT (NPI 1750809448) is an individual sports provider in St Petersburg, Florida, licensed in Florida (PT34062) and active in the NPI registry since September 2017. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1750809448
Entity TypeIndividualMale
Primary Taxonomy2251S0007X
Provider Legal NameBRIAN PAUL BROUSSARDCredential: DPT
Location Address111 2ND AVE NE STE 1401St Petersburg, FL 33701-3480
Mailing Address111 2nd Ave Ne Ste 1401St Petersburg, FL 33701-3480 · (727) 258-7224
Phone(727) 258-7224
Sole ProprietorNo
Enumeration DateSeptember 2, 2017
Last NPPES UpdateJune 9, 20213 updates tracked since enumeration
NPPES CertifiedFebruary 9, 2021
✔ NPI 1750809448 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · SportsRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251S0007X
Licenses✔ Licensed in FL · PT34062✔ Licensed in VA · 1679719421
Definition
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, pathology and pathophysiology, medical and surgical intervention, and health and wellness, as well as rehabilitation/return to sports, management of acute injury/illness, medical and surgical consideration, injury prevention, and sports performance enhancement.
111 2ND AVE NE STE 1401, St Petersburg, FL 33701
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Secondary Practice Locations 2

Location 12751 Prosperity AveFairfax, VA 22031-4397 · Phone (703) 237-3930
Location 215049 Bruce B Downs BlvdTampa, FL 33647-1388 · Phone (813) 563-7668

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALLIANCE SPORTS REHAB
Physical Therapist (Sports)
111 2ND AVE NE STE 1401
ST PETERSBURG, FL 33701
Pinellas County (727) 258-7224
ALLIANCE REGENERATIVE AND PERFORMANCE MEDICINE, PLLC
Family Medicine (Sports Medicine)
111 2ND AVE NE STE 1401
ST PETERSBURG, FL 33701
Pinellas County (727) 258-7224
DR. JOHN BROUSSARD DO
Family Medicine (Sports Medicine)
111 2ND AVE NE STE 1401
ST PETERSBURG, FL 33701
Pinellas County (727) 258-7224
ALEXANDER EBINGER
Physical Therapist (Sports)
111 2ND AVE NE STE 1401
ST PETERSBURG, FL 33701
Pinellas County (727) 258-7224
DR. DENNIS COLON DPT
Physical Therapist
111 2ND AVE NE STE 1401
ST PETERSBURG, FL 33701
Pinellas County (727) 258-7224

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brian Broussard's NPI number?

The NPI number for Brian Broussard is 1750809448. It was assigned to this individual provider in the NPPES registry on September 2, 2017.

Where is Brian Broussard located?

Brian Broussard practices at 111 2nd Ave NE Ste 1401, St Petersburg, FL 33701. The listed phone number is (727) 258-7224.

What is Brian Broussard's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Sports, with taxonomy code 2251S0007X.

When was this NPI record last updated?

The NPPES record for Brian Broussard was last updated on June 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.