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General NPI Number Information
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NPI Number | 1083567127
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Entity Type | Organization
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Legal Business Name | BLOOMING BEHAVIOR THERAPY LLC
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Dates
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Enumeration Date | 02/18/2026
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 1350 ORANGE AVE STE 220
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City | WINTER PARK
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State | FL
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Zip | 32789-4945
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Country | US
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Telephone | 239-800-9289
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Fax | 239-800-1953
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Provider Business Mailing Address
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Address Line | 43 BARKLEY CIR STE 101
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City | FORT MYERS
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State | FL
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Zip | 33907-7517
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Country | US
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Telephone | 239-839-0323
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANA L TRUJILLO
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Credential |
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Telephone | 239-839-0323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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