| Bloom Behavior Services Llc | |
|
6239 Edgewater Dr Ste N4 Orlando FL 32810-4736 | |
| (407) 900-5532 | |
| (321) 244-0645 |
| Full Name | Bloom Behavior Services Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 6239 Edgewater Dr Ste N4, Orlando, Florida |
| Authorized Official Name and Position | Mia Richards (OWNER) |
| Authorized Official Contact | 4077584948 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Behavior Services Llc 6239 Edgewater Dr Ste N4 Orlando FL 32810-4736 Ph: (407) 900-5532 | Bloom Behavior Services Llc 6239 Edgewater Dr Ste N4 Orlando FL 32810-4736 Ph: (407) 900-5532 |
| NPI Number | 1790291649 |
|---|---|
| Provider Enumeration Date | 12/14/2017 |
| Last Update Date | 05/28/2024 |
| Certification Date | 05/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790291649 | NPI | - | NPPES |
| 018854500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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