Bloom Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH10626 Issued in FL

Legal business name

BLOOM CHIROPRACTIC, LLC

Practice address

545 W Granada Blvd
Ormond Beach, FL 32174-5103

Phone

(386) 672-6243

Fax

(386) 677-7463

NPI assigned

Mar 18, 2018

Last updated

Aug 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Audrey Isabel Gil de Rubio, DC

Title

Owner

Phone

(787) 587-5267

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1521331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1184127995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6634 MERRYVALE LN",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321284037",
            "telephone_number": "787-587-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 W GRANADA BLVD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745103",
            "telephone_number": "386-672-6243",
            "fax_number": "386-677-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-18",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "GIL DE RUBIO",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_middle_name": "ISABEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-587-5267",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.