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General NPI Number Information
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NPI Number | 1073193991
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Entity Type | Organization
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Legal Business Name | BLESSED LEGACY LLC
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 2072 MAGUIRE AVE
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City | SPRING HILL
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State | FL
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Zip | 34608-5037
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Country | US
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Telephone | 813-756-8056
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Fax | 813-725-6424
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Provider Business Mailing Address
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Address Line | 2072 MAGUIRE AVE
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City | SPRING HILL
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State | FL
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Zip | 34608-5037
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Country | US
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Telephone | 954-638-3770
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YADIRA SUAREZ-PITA
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Credential | MS.ED., BCBA
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Telephone | 954-638-3770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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