| Blossom Minds Llc | |
|
2645 Executive Park Dr Ste 534 Weston FL 33331-3624 | |
| (954) 512-4827 | |
| Not Available |
| Full Name | Blossom Minds Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2645 Executive Park Dr Ste 534, Weston, Florida |
| Authorized Official Name and Position | Maria Corujo Feijoo (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9545124827 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossom Minds Llc 2645 Executive Park Dr Ste 534 Weston FL 33331-3624 Ph: (954) 512-4827 | Blossom Minds Llc 2645 Executive Park Dr Ste 534 Weston FL 33331-3624 Ph: (954) 512-4827 |
| NPI Number | 1871217620 |
|---|---|
| Provider Enumeration Date | 09/26/2022 |
| Last Update Date | 09/26/2022 |
| Certification Date | 09/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871217620 | NPI | - | NPPES |
| 1164975355 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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