NPIMap

Organization Active NPI

Alliance Sports Rehab

  • Sports Physical Therapist
  • St Petersburg, FL
National Provider Identifier
1033701123
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
Legal business name
ALLIANCE SPORTS REHAB
Practice address
111 2ND Ave NE Ste 1401
St Petersburg, FL 33701-3480
Phone
(727) 258-7224
NPI assigned
Feb 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brian Broussard, DPTNPI 1750809448
Title
Co-Owner
Phone
(727) 258-7224

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251S0007X Primary

Addresses

Primary practice location

111 2ND Ave NE Ste 1401
St Petersburg, FL 33701-3480

Mailing address

111 2ND Ave NE Ste 1401
St Petersburg, FL 33701-3480
Phone (727) 258-7224

National Provider Directory

National Provider Directory

Locations

111 2nd Ave NE
Ste 1401
St Petersburg, FL 33701
Phone (727) 258-7224

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612828800000",
    "number": "1033701123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 2ND AVE NE STE 1401",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013480",
            "telephone_number": "727-258-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 2ND AVE NE STE 1401",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013480",
            "telephone_number": "727-258-7224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE SPORTS REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A",
        "authorized_official_last_name": "BROUSSARD",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "727-258-7224",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.