MEDICARE: BLOOM WITH THERAPY SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1558171322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOM WITH THERAPY SERVICES INC

Provider Business Mailing Address
First Line	:	3230 SW 118TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-3143
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3230 SW 118TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-3143
Country	:	US
Telephone Number	:	305-930-0256
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	VERONICA LEZCANO RAMOS
Credential	:
Telephone Number	:	305-930-0256

Provider Enumeration Date	:	01/13/2025
Last Update Date	:	01/13/2025

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Directions to “BLOOM WITH THERAPY SERVICES INC ” Practice Location

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