Bloom Pediatrics, PLLC

Organization Active NPI Pediatric Nurse Practitioner · Callahan, FL

NPI 1104760537 · NPPES record last updated Apr 16, 2026

Key facts

NPI
1104760537
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
Legal business name
BLOOM PEDIATRICS, PLLC
Practice address
542194 US Highway 1
Callahan, FL 32011-8109
Phone
(904) 675-3076
NPI assigned
Apr 16, 2026
Organization subpart
No

Authorized official

Name
Jessica Raines
Title
Owner
Phone
(904) 675-3076

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

542194 US Highway 1
Callahan, FL 32011
Phone (904) 339-5826

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0200X Yes

Addresses

Primary practice location

542194 US Highway 1
Callahan, FL 32011-8109

Mailing address

542194 US Highway 1
Callahan, FL 32011-8109

Other providers in Callahan, FL

All providers in Callahan, FL · Pediatric Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.