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General NPI Number Information
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NPI Number | 1396693636
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Entity Type | Organization
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Legal Business Name | BLUE SPRING
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Dates
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Enumeration Date | 03/20/2026
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Last Update Date | 03/20/2026
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Provider Practice Location Address
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Address Line | 7210 N MANHATTAN AVE APT 2612
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City | TAMPA
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State | FL
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Zip | 33614-3728
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Country | US
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Telephone | 813-595-0134
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Fax |
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Provider Business Mailing Address
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Address Line | 7210 N MANHATTAN AVE APT 2612
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City | TAMPA
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State | FL
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Zip | 33614-3728
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RBT
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Name | NATALIE HERNANDEZ PRADO
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Credential |
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Telephone | 813-595-0134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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