Healthcare Provider Details

I. General information

NPI: 1578479051
Provider Name (Legal Business Name): BLOOM HEALTH CONNECT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 N UNIVERSITY DR STE 500
PLANTATION FL
33324-2009
US

IV. Provider business mailing address

261 N UNIVERSITY DR STE 500
PLANTATION FL
33324-2009
US

V. Phone/Fax

Practice location:
  • Phone: 561-352-5618
  • Fax:
Mailing address:
  • Phone: 561-352-5618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. MARIE BEATRICE DUPLESSY
Title or Position: MANAGER
Credential: NP
Phone: 561-352-5618