Provider Demographics
NPI:1689203986
Name:BALSARA, CHARMI
Entity type:Individual
Prefix:
First Name:CHARMI
Middle Name:
Last Name:BALSARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 S DIXIE HWY STE 103
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5423
Mailing Address - Country:US
Mailing Address - Phone:305-520-9445
Mailing Address - Fax:
Practice Address - Street 1:134 S DIXIE HWY STE 103
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-5423
Practice Address - Country:US
Practice Address - Phone:305-520-9445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7117412084P0800X
SC937252084P0800X
MI43015123132084P0800X
FLME1645152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry