Bloom Mental Health and Wellness, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

BLOOM MENTAL HEALTH AND WELLNESS, LLC

Practice address

1540 International Pkwy Ste 2000
Lake Mary, FL 32746-5096

Phone

(407) 554-9970

NPI assigned

Mar 25, 2024

Organization subpart

No

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

Authorized official

Name

Lari J Quintero, APRNNPI 1811255599

Title

Owner

Phone

(407) 252-7011

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Lari J Quintero, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Longwood, FL
  • NPI 1811255599
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1285484204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 INTERNATIONAL PKWY STE 2000",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465096",
            "telephone_number": "407-252-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 INTERNATIONAL PKWY STE 2000",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465096",
            "telephone_number": "407-554-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM MENTAL HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "QUINTERO",
        "authorized_official_first_name": "LARI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-252-7011",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tramaine Renaldo Blash
• Kristina F Blaske
• Kelly Blaylock
• Blessed Home Health Care, LLC
• Aaliyah Chimere Bloise
• Jeromi Blount
• Bluesprig
• Jennifer C Blum-Patty, COTA
• Julie Lynn Bogle, M.ED, CCC-SLP
• Candice Allen Bond, RN

• Adult Mental Health Clinic/Center in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.