Healthcare Provider Details

I. General information

NPI: 1811850530
Provider Name (Legal Business Name): BLUESPRIG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4235 RACHEL BLVD
SPRING HILL FL
34607-2529
US

IV. Provider business mailing address

300 INTERNATIONAL PKWY STE 200
LAKE MARY FL
32746-5028
US

V. Phone/Fax

Practice location:
  • Phone: 352-505-9428
  • Fax:
Mailing address:
  • Phone: 866-610-0580
  • Fax: 866-611-1558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY BILDSTEIN
Title or Position: BEHAVIOR TECHNICIAN
Credential:
Phone: 352-263-0417