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General NPI Number Information
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NPI Number | 1295443893
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Entity Type | Organization
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Legal Business Name | BLUE LIFE THERAPY INC
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Dates
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Enumeration Date | 11/11/2022
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 888 NW 27TH AVE STE 5
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City | MIAMI
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State | FL
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Zip | 33125-3000
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Country | US
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Telephone | 786-307-6370
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Fax | 888-543-7136
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Provider Business Mailing Address
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Address Line | 888 NW 27TH AVE STE 5
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City | MIAMI
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State | FL
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Zip | 33125-3000
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Country | US
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Telephone | 786-307-6370
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Fax | 888-543-7136
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROSALIA GALAN GOICOCHEA
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Credential | BCBA
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Telephone | 786-307-6370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | 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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