Alive & Blossom Healthcare LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

ALIVE & BLOSSOM HEALTHCARE LLC

Doing business as

B12 Health Mobile

Practice address

190 Champions Vue Loop Unit 408
Davenport, FL 33897-4857

Phone

(954) 394-4793

NPI assigned

Mar 5, 2021

Last updated

Mar 5, 2021By 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

Margaly Valcourt, ARNP

Title

Manager

Phone

(954) 394-4793

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• B12 Health Mobile Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1669067146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 CHAMPIONS VUE LOOP UNIT 408",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338974857",
            "telephone_number": "954-394-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 CHAMPIONS VUE LOOP UNIT 408",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338974857",
            "telephone_number": "954-394-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALIVE & BLOSSOM HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "VALCOURT",
        "authorized_official_first_name": "MARGALY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-394-4793",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "0000000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "DAVENPORT",
            "affiliation": "N",
            "endpointDescription": "n/a",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "n/a",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "n/a",
            "address_1": "190 Champions Vue Loop Unit 408",
            "city": "Davenport",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338974857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "B12 Health Mobile",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Anthony Alfonso
• Taneisha Alford
• Dylan Louis Algorri
• Terrance Mohamed Ali
• Alive & Blossom Healthcare LLC (B12 Health Mobile)
• Mark Alkass, MD
• All About Women PLLC
• Allen Optical LLC.
• Jeff David Alsy
• Barbara Michel Altamar Mendoza, BACB559120

• Primary Care Nurse Practitioner in Davenport, FL
• Providers in Davenport, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.