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NPI Code Detail

MEDICARE: BLUESPRIG PEDIATRICS

MEDICARE: BLUESPRIG PEDIATRICS
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1578422853
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUESPRIG PEDIATRICS
Provider Business Mailing Address
First Line : 4085 HANCOCK BRIDGE PKWY STE 101
Second Line :
City : NORTH FORT MYERS
State : FL
Zip : 33903-7220
Country : US
Telephone Number : 239-677-3767
Fax Number :
Provider Business Practice Location Address
First Line : 4085 HANCOCK BRIDGE PKWY STE 101
Second Line :
City : NORTH FORT MYERS
State : FL
Zip : 33903-7220
Country : US
Telephone Number : 239-677-3767
Fax Number :
Authorized Official
Title or Position : BEHAVIOR TECHNICIAN
Name : MISS BROOKLYN PATHERESE RIPLEY
Credential :
Telephone Number : 772-521-4582
Provider Enumeration Date : 01/21/2026
Last Update Date : 01/21/2026

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Directions to “BLUESPRIG PEDIATRICS ” Practice Location

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