Healthcare Provider Details

I. General information

NPI: 1386554426
Provider Name (Legal Business Name): NEOBLOOM KIDS THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 E OAKLAND PARK BLVD # 200-15
FORT LAUDERDALE FL
33306-1801
US

IV. Provider business mailing address

2810 E OAKLAND PARK BLVD # 200-15
FORT LAUDERDALE FL
33306-1801
US

V. Phone/Fax

Practice location:
  • Phone: 305-610-5442
  • Fax:
Mailing address:
  • Phone: 305-610-5442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: JOSE RODRIGUEZ BENDICHO
Title or Position: OWNER
Credential:
Phone: 305-610-5442