Healthcare Provider Details

I. General information

NPI: 1033065594
Provider Name (Legal Business Name): BLOOMING ROSES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2026
Last Update Date: 03/07/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10660 ROYAL CYPRESS WAY
ORLANDO FL
32836-6528
US

IV. Provider business mailing address

10660 ROYAL CYPRESS WAY
ORLANDO FL
32836-6528
US

V. Phone/Fax

Practice location:
  • Phone: 561-200-5000
  • Fax:
Mailing address:
  • Phone: 561-200-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAIMUNDO DA SILVA REZENDE
Title or Position: DIRECTOR
Credential: MD
Phone: 561-200-5000