Healthcare Provider Details
I. General information
NPI: 1184537466
Provider Name (Legal Business Name): BLOOM INTEGRATED CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4471 NW 185TH ST
MIAMI GARDENS FL
33055-3080
US
IV. Provider business mailing address
4471 NW 185TH ST
MIAMI GARDENS FL
33055-3080
US
V. Phone/Fax
- Phone: 404-396-9260
- Fax:
- Phone: 404-396-9260
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PHYLESIA
MINTZ
Title or Position: PRESIDENT
Credential:
Phone: 404-396-9260