Blossom Behavior Center LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

BLOSSOM BEHAVIOR CENTER LLC

Practice address

13706 SW 56TH St Ste 105-106
Miami, FL 33175-6036

Phone

(786) 688-2630

Fax

(786) 513-8495

NPI assigned

Jan 24, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisdeybys Batlle LorenteNPI 1194364489

Title

President

Phone

(786) 523-4289

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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

• Lisdeybys Batlle Lorente

  • Social Worker
  • Miami, FL
  • NPI 1194364489
  NPD Authorized official
• Ravishanker Villaflor Sujakumar, D.O.

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1700161700
  Medicare reassignment
• Carlos Alberto Larrauri, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami, FL
  • NPI 1538668298
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667260800000",
    "number": "1174153449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13706 SW 56TH ST STE 105-106",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331756036",
            "telephone_number": "786-688-2630",
            "fax_number": "786-513-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13706 SW 56TH ST STE 105-106",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331756036",
            "telephone_number": "786-688-2630",
            "fax_number": "786-513-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM BEHAVIOR CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-24",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A",
        "authorized_official_last_name": "BATLLE LORENTE",
        "authorized_official_first_name": "LISDEYBYS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-523-4289"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Blossoming Minds LLC
• Blossoms Behaviora Center LLC
• William R Blouin, MSN,ARNP,CPNP
• Martha Henao Bloyer, MPT
• Blue Angel Adult Day Care

• Case Management Agency in Miami, FL
• Providers in Miami, FL by specialty
• Case Management Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.