Healthcare Provider Details

I. General information

NPI: 1538088588
Provider Name (Legal Business Name): EVERBLOOM LIVING CO. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1189 NW 45TH TER
LAUDERHILL FL
33313-6625
US

IV. Provider business mailing address

1189 NW 45TH TER
LAUDERHILL FL
33313-6625
US

V. Phone/Fax

Practice location:
  • Phone: 954-853-5705
  • Fax: 954-853-5705
Mailing address:
  • Phone: 954-853-5705
  • Fax: 954-853-5705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JULIENNE R DADAILLE
Title or Position: OWNER
Credential:
Phone: 954-853-5705