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General NPI Number Information
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NPI Number | 1538081773
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Entity Type | Organization
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Legal Business Name | BLOOM INTO BALANCE PSYCHIATRY & WELLNESS, PLLC
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/29/2026
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Provider Practice Location Address
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Address Line | 7901 4TH ST N # 25245
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City | SAINT PETERSBURG
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State | FL
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Zip | 33702-4305
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Country | US
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Telephone | 813-710-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N # 25245
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City | SAINT PETERSBURG
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State | FL
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Zip | 33702-4305
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Country | US
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Telephone | 813-710-1600
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Fax |
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Authorized Official
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Title or Position | FOUNDER/PROVIDER
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Name | JESSICA SPENCER
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Credential | APRN. PMHNP-BC
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Telephone | 813-710-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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