MEDICARE: BLUE SPRIG CLINICAL SERVICES, 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	251C00000X	Developmentally Disabled Services Day Training Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1902593254
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE SPRIG CLINICAL SERVICES, INC

Provider Business Mailing Address
First Line	:	9520 SW 40TH ST STE 101A
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-4074
Country	:	US
Telephone Number	:	786-443-2109
Fax Number	:

Provider Business Practice Location Address
First Line	:	9520 SW 40TH ST STE 101A
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-4074
Country	:	US
Telephone Number	:	786-443-2109
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ANISLEY RUBIE
Credential	:
Telephone Number	:	786-443-2109

Provider Enumeration Date	:	04/18/2023
Last Update Date	:	11/10/2025

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