Organization
BIONIC BLOOM
Active
Organization
BIONIC BLOOM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA FISHER PHD (CEO)
(727) 490-9911
Entity
Organization
Contact information
Practice address
13575 58TH ST N STE 203, CLEARWATER, FL 33760-3740
(727) 490-9911
Mailing address
2232 2ND AVE S UNIT 136, ST PETERSBURG, FL 33712-1210
(727) 490-9911
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/05/2022
Last updated
03/22/2026
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