| Blossoming Wellbeing Telepsychiatry | |
|
9800 4th St N Ste 200 St Petersburg FL 33702-2462 | |
| (833) 399-0957 | |
| (727) 335-1174 |
| Full Name | Blossoming Wellbeing Telepsychiatry |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Medicine |
| Location | 9800 4th St N Ste 200, St Petersburg, Florida |
| Authorized Official Name and Position | La Tasha Al-jarboua (OWNER/CEO) |
| Authorized Official Contact | 3042378733 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossoming Wellbeing Telepsychiatry 9800 4th St N Ste 200 St Petersburg FL 33702-2462 Ph: (833) 399-0957 | Blossoming Wellbeing Telepsychiatry 9800 4th St N Ste 200 St Petersburg FL 33702-2462 Ph: (833) 399-0957 |
| NPI Number | 1992319560 |
|---|---|
| Provider Enumeration Date | 09/01/2020 |
| Last Update Date | 11/17/2020 |
| Certification Date | 11/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992319560 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Primary |
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