Organization Active NPI

Neurobloom Therapy LLC

  • Speech-Language Pathologist
  • Titusville, FL
National Provider Identifier
1609794411
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
NEUROBLOOM THERAPY LLC
Practice address
323 S Washington Ave # 312
Titusville, FL 32796-3593
Phone
(689) 986-4560
NPI assigned
Jul 8, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Authorized official

Name
Jennifer Denise Boffil, CCC-SLP
Title
Owner/ Speech Language Pathologist
Phone
(689) 986-4560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

323 S Washington Ave # 312
Titusville, FL 32796-3593

Mailing address

323 S Washington Ave # 312
Titusville, FL 32796-3593

National Provider Directory

National Provider Directory

Locations

323 S Washington Ave
#312
Titusville, FL 32796

NPI Registry JSON

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

{
    "created_epoch": "1783468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1609794411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S WASHINGTON AVE # 312",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S WASHINGTON AVE # 312",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963593",
            "telephone_number": "689-986-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROBLOOM THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-08",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "BOFFIL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER/ SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "689-986-4560",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.