Blossoming Wellbeing Corp.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

BLOSSOMING WELLBEING CORP.

Practice address

6622 32ND Way S
St Petersburg, FL 33712-5408

Phone

(833) 779-2633

NPI assigned

Jul 7, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

La Tasha Al-Jarboua, PA-CNPI 1588078000

Title

Ceo

Phone

(833) 779-2633

Specialties & licenses 4

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• La Tasha Al-Jarboua, PA-C

  • Child & Adolescent Psychiatry Physician
  • St Petersburg, FL
  • NPI 1588078000

  Addiction Psychiatry

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562457600000",
    "number": "1972165231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 34TH ST S STE 135",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337114511",
            "telephone_number": "833-779-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6622 32ND WAY S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337125408",
            "telephone_number": "833-779-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOMING WELLBEING CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-07",
        "last_updated": "2019-07-07",
        "status": "A",
        "authorized_official_last_name": "AL-JARBOUA",
        "authorized_official_first_name": "LA TASHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "833-779-2633",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor Blose
• Nancy Beth Bloss Tumarkin, M.D.
• Sonja Katherine Blosser, PTA
• Blossom Family Chiropractic
• Blossom Medical Center Corp
• Blossoming Wellbeing Telepsychiatry
• Brandi M Blount, CRNA
• Blue Bridge Medical Inc
• Blue Ridge by the Lake LLC
• Blue Wellness, LLC

• Psychiatry Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.