Healthcare Provider Details

I. General information

NPI: 1750205340
Provider Name (Legal Business Name): EVERBLOOM FAMILY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8358 W OAKLAND PARK BLVD STE 202I
SUNRISE FL
33351-7341
US

IV. Provider business mailing address

8358 W OAKLAND PARK BLVD STE 202I
SUNRISE FL
33351-7341
US

V. Phone/Fax

Practice location:
  • Phone: 786-448-9478
  • Fax:
Mailing address:
  • Phone: 786-448-9478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MIGNELYS DIAZ
Title or Position: OWNER
Credential:
Phone: 786-448-9478