Healthcare Provider Details

I. General information

NPI: 1801726146
Provider Name (Legal Business Name): BLOOMING HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4410 W 16TH AVE STE 61
HIALEAH FL
33012-7194
US

IV. Provider business mailing address

4410 W 16TH AVE STE 61
HIALEAH FL
33012-7194
US

V. Phone/Fax

Practice location:
  • Phone: 305-303-0754
  • Fax:
Mailing address:
  • Phone: 305-303-0754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YOANED SANTANA
Title or Position: PRESIDENT
Credential: APRN
Phone: 305-303-0754