Blooming Health Center LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BLOOMING HEALTH CENTER LLC

Practice address

1701 Park Center Dr Ste 100
Orlando, FL 32835-6235

Phone

(407) 301-7299

NPI assigned

Dec 12, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Raquel Ralat Martinez, LCSWNPI 1538655337

Title

Owner

Phone

(407) 301-7299

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Blooming Health Center LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Raquel Ralat Martinez

  • Mental Health Counselor
  • Lake Alfred, FL
  • NPI 1538655337
  Medicare reassignment NPD Authorized official
• Nidia Alicia Smith-Villanueva

  • Case Manager/Care Coordinator
  • Orlando, FL
  • NPI 1467814707
  NPD (past)

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738281600000",
    "number": "1912714932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 PARK CENTER DR",
            "address_2": "STE. 100 OFFICE 131",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356235",
            "telephone_number": "407-301-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 PARK CENTER DR STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356235",
            "telephone_number": "407-301-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMING HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-12",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A",
        "authorized_official_last_name": "RALAT MARTINEZ",
        "authorized_official_first_name": "RAQUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-301-7299",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122081800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blooming Health Center LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Blooming Health Center LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Alyssa Bloomer, BCBA
• Blooming Keiki Behavioral Services LLC
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• Blooming With Hope Therapy
• Elizabeth Frye Blossey, CNM, ARNP
• Blossom Health Center

• Community/Behavioral Health Agency in Orlando, FL
• Providers in Orlando, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; 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.