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General NPI Number Information
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NPI Number | 1588804843
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE PSYCHIATRY INC
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Dates
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Enumeration Date | 02/26/2009
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 3392 MAGIC OAK LN
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City | SARASOTA
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State | FL
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Zip | 34232-1822
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Country | US
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Telephone | 941-371-7997
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Fax | 941-379-7667
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Provider Business Mailing Address
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Address Line | 3392 MAGIC OAK LN
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City | SARASOTA
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State | FL
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Zip | 34232-1822
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Country | US
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Telephone | 941-379-7997
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Fax | 941-379-7667
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Authorized Official
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Title or Position | PRESIDENT
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Name | VALERIE BALANDRA
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Credential | ARNP
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Telephone | 941-371-7997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME10232
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN13479662
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License Number State | FL
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