| Balance Psychiatry And Wellness Llc | |
|
142 E Gore St Orlando FL 32806-1223 | |
| (307) 388-0400 | |
| Not Available |
| Full Name | Balance Psychiatry And Wellness Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 142 E Gore St, Orlando, Florida |
| Authorized Official Name and Position | Briane Olson (OWNER) |
| Authorized Official Contact | 3073880400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Balance Psychiatry And Wellness Llc 142 E Gore St Orlando FL 32806-1223 Ph: (307) 388-0400 | Balance Psychiatry And Wellness Llc 142 E Gore St Orlando FL 32806-1223 Ph: (307) 388-0400 |
| NPI Number | 1063256089 |
|---|---|
| Provider Enumeration Date | 06/24/2024 |
| Last Update Date | 07/01/2024 |
| Certification Date | 07/01/2024 |
| Medicare PECOS PAC ID | 7618416074 |
|---|---|
| Medicare Enrollment ID | O20240829000541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063256089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
| Provider Name | Todd Jason Broder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699849349 PECOS PAC ID: 3375675978 Enrollment ID: I20100716000820 |
| Provider Name | Hannah E Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881035178 PECOS PAC ID: 0648408344 Enrollment ID: I20131231001489 |
| Provider Name | Briane Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316377997 PECOS PAC ID: 9335489517 Enrollment ID: I20191220001799 |
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