DR. BALSAM FANOUS (NPI# 1619024007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619024007 |
| Entity Type | Individual |
| Full Name | DR. BALSAM FANOUS |
| Credential | M.D. |
| Practice Address |
12512 Bruce B Downs Blvd Tampa FL 33612-9209 |
| Practice Telephone | 8139778700 |
| Practice Fax Number | 8139712029 |
| Mailing Telephone | 8139778700 |
| Mailing Fax Number | 8139712029 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
ME41656 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
12512 BRUCE B DOWNS BLVD |
| City | TAMPA |
| State | FL |
| Zip Code | 33612-9209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669498002 | Northside Behavioral Health Center, Inc. | Psychiatric Hospital | 12512 Bruce B Downs Blvd, Tampa, FL 33612 | 2006-07-15 |
| 1205327558 | Savannah Sterns | Counselor | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2018-05-22 |
| 1902303357 | Amber E Holbin | Counselor | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2018-04-11 |
| 1346743036 | Anthony Jose Silverio | Counselor | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2018-03-09 |
| 1063914422 | Brittany Melendez | Counselor | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2018-03-01 |
| 1134643463 | Kamille Naomi Harris | Counselor | 12512 Bruce B Downs Blvd, Tampa, FL 33613 | 2017-07-28 |
| 1053832022 | Kelly Elizabeth Solberg | Social Worker | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2017-06-29 |
| 1144755968 | Rossen Munroe | Counselor | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2017-04-30 |
| 1396277026 | Anne Marie Bowlin | Licensed Practical Nurse | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2017-03-31 |
| 1902341720 | Joseph Marten | Registered Nurse | 12512 Bruce B Downs Blvd, Tampa, FL 33612-9209 | 2017-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286767 | Daniel Jimenez | Physical Therapist | 13000 Bruce B Downs Blvd, Tampa, Fl, Tampa, FL 33612 | 2020-08-19 |
| 1700426830 | Taz Stacy | Behavior Technician | 2701 University Square Drive, Tampa, FL 33612 | 2020-01-07 |
| 1841853215 | Eric Austen Keeler | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-20 |
| 1346700242 | Caitlyn Victoria Cartwright | Student in an Organized Health Care Education/Training Program | 12901 Bruce B. Downs Blvd., Mdc5, Tampa, FL 33612 | 2019-03-25 |
| 1720552953 | Marijo Bilitski | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd # Blvd5, Tampa, FL 33612 | 2019-01-22 |
| 1790259190 | Belkis Aleman | Nurse Practitioner | 205 E Busch Blvd, Tampa, FL 33612 | 2019-01-18 |
| 1811469133 | Stephanie Stegner | Physician Assistant | 12901 Bruce B Downs Blvd Mdc 5, Tampa, FL 33612 | 2018-12-27 |
| 1053889857 | Alysia Heather Siegel | Psychologist | 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 | 2018-11-09 |
| 1295202489 | Daisy Baby Pulinilkumkalayil | Nurse Practitioner | 1426 W. Bush Blvd. Suite #105, Suite #105, Tampa, FL 33612 | 2018-10-26 |
| 1649745258 | Rachel Rene Shelton | Specialist/Technologist | Orthopedics and Sports Medicine, 13330 Usf Laurel Drive, Tampa, FL 33612 | 2018-10-10 |
| Find all providers in zip 33612 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043776859 | Ann Park | Psychiatry & Neurology | 1002b S Church Ave # 320056, Tampa, FL 33629-5018 | 2019-02-17 |
| 1730652645 | South Tampa Psychiatry | Psychiatry & Neurology | 2919 W Swann Ave Ste 104, Tampa, FL 33609-4049 | 2019-01-03 |
| 1902393069 | Tampa Bay Center for Psychological Health | Psychiatry & Neurology | 14924 Casey Rd Unit 3b, Tampa, FL 33624-2317 | 2018-04-15 |
| 1508222324 | Behavioral Health Science of West Florida, LLC | Psychiatry & Neurology | 508 S Habana Ave Ste 380, Tampa, FL 33609-4144 | 2016-01-08 |
| 1912249228 | Scott Edward Nelson | Psychiatry & Neurology | 3515 E Fletcher Ave # 14, Tampa, FL 33613 | 2013-03-25 |
| 1649533787 | Sumaira Fayyaz Khan Md LLC | Psychiatry & Neurology | 18022 Cozumel Isle Dr, Tampa, FL 33647-3373 | 2012-06-22 |
| 1225355340 | Chetan P Gandhy | Psychiatry & Neurology | 13330 Usf Laurel Dr., Tampa, FL 33612-4742 | 2010-04-29 |
| 1396060174 | Shirrin Ahmadi-davis | Psychiatry & Neurology | 2727 W Mlk Blvd, Suite 640, Tampa, FL 33607-6383 | 2010-04-05 |
| 1104141423 | Pragneshkumar P Patel | Psychiatry & Neurology | 613 W Dr Martin Luther King Jr Blvd Ste 102, Tampa, FL 33603-3400 | 2010-03-30 |
| 1497081624 | Nancy Dinwoodie | Psychiatry & Neurology | 3515 Heards Ferry Dr, Tampa, FL 33618-2922 | 2009-10-22 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.