MEDICARE: BLOOMING BEHAVIORAL HEALTH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1124970488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOMING BEHAVIORAL HEALTH INC

Provider Business Mailing Address
First Line	:	3600 S STATE ROAD 7 STE 344
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-7203
Country	:	US
Telephone Number	:	754-799-3780
Fax Number	:	754-547-6353

Provider Business Practice Location Address
First Line	:	3600 S STATE ROAD 7 STE 344
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-7203
Country	:	US
Telephone Number	:	754-799-3780
Fax Number	:	754-547-6353

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CELIA SANTOS
Credential	:
Telephone Number	:	754-799-3780

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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