Blossom ABA Services LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BLOSSOM ABA SERVICES LLC

Practice address

17670 NW 78TH Ave Ste 212
Hialeah, FL 33015-3670

Phone

(305) 501-1438

NPI assigned

Apr 18, 2024

Organization subpart

No

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

Authorized official

Name

Pedro Antonio Perez

Title

President

Phone

(305) 510-2283

Specialties & licenses 1

Addresses

Other names 1

• BLOSSOM ABA SERVICES LLC Former legal business name

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

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1871348458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17670 NW 78TH AVE STE 212",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330153670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17670 NW 78TH AVE STE 212",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330153670",
            "telephone_number": "305-501-1438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM ABA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-510-2283"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLOSSOM ABA SERVICES LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Behavior Analyst in Hialeah, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.