Healthcare Provider Details

I. General information

NPI: 1538035951
Provider Name (Legal Business Name): BLOOM & BALANCE PSYCHIATRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 PROFESSIONAL PKWY STE 200
LAKEWOOD RANCH FL
34240-8473
US

IV. Provider business mailing address

4116 BUTTE TRL
BRADENTON FL
34211-1537
US

V. Phone/Fax

Practice location:
  • Phone: 941-352-9832
  • Fax: 941-855-3009
Mailing address:
  • Phone: 941-352-9832
  • Fax: 941-855-3009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: ANNABELLE JOY CARNEY
Title or Position: OWNER/PROVIDER
Credential: PA
Phone: 941-352-9832