Individual
DR. BALSAM FANOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700
(813) 971-2029
Mailing address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700
(813) 971-2029
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME41656
FL
Other
Enumeration date
01/05/2007
Last updated
07/09/2007
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