Healthcare Provider Details

I. General information

NPI: 1538018734
Provider Name (Legal Business Name): BLUME FLEUR FLOWER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 N MAIN ST STE 530
PUEBLO CO
81003-3179
US

IV. Provider business mailing address

10109 PALISADE RIDGE DR
COLORADO SPRINGS CO
80920-1492
US

V. Phone/Fax

Practice location:
  • Phone: 719-334-1201
  • Fax:
Mailing address:
  • Phone: 719-334-1201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MELANIE F SANDOVAL
Title or Position: PRESIDENT/CLINICAL PROVIDER
Credential: PHD, PMHNP-BC
Phone: 719-334-1201