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General NPI Number Information
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NPI Number | 1689427130
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Entity Type | Organization
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Legal Business Name | EMBERS TO BLOOM LLC
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Dates
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Enumeration Date | 04/05/2024
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 159 CROCKER PARK BLVD STE 400
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City | WESTLAKE
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State | OH
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Zip | 44145-8147
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Country | US
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Telephone | 513-513-6237
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Fax |
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Provider Business Mailing Address
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Address Line | 9300 CONROY WINDERMERE RD UNIT 3089
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City | WINDERMERE
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State | FL
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Zip | 34786-5121
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Country | US
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Telephone | 321-895-2676
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | NICHOLE DEMESMIN
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Credential |
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Telephone | 407-230-3954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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