Healthcare Provider Details

I. General information

NPI: 1063376838
Provider Name (Legal Business Name): BLOOMING BUTTERFLIES SPEECH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

682 6TH ST. NE
NAPLES FL
34120
US

IV. Provider business mailing address

13585 N TAMIAMI TRAIL STE 12 #1044
NAPLES FL
34110
US

V. Phone/Fax

Practice location:
  • Phone: 239-658-4029
  • Fax:
Mailing address:
  • Phone: 239-658-4029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH D RODRIGUEZ
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M.S.,CCC-SLP
Phone: 239-658-4029