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Organization

BLOSSOMING WELLBEING TELEPSYCHIATRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LA TASHA AL-JARBOUA PA-C (OWNER/CEO)
(304) 237-8733
Entity
Organization

Contact information

Practice address
9800 4TH ST N STE 200, ST PETERSBURG, FL 33702-2462
(833) 399-0957
(727) 335-1174
Mailing address
9800 4TH ST N STE 200, ST PETERSBURG, FL 33702-2462
(833) 399-0957
(727) 335-1174

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary

Other

Enumeration date
09/01/2020
Last updated
11/17/2020
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