NPIMap

Organization Active NPI

Behavior Blossoms LLC

  • Behavior Analyst
  • Orlando, FL
National Provider Identifier
1982270781
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BEHAVIOR BLOSSOMS LLC
Practice address
2484 Sand Lake Rd
Orlando, FL 32809-7672
Phone
(407) 342-7939
Fax
(888) 808-5278
NPI assigned
Jun 2, 2021
Last updated
Jun 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Authorized official

Name
Justin Kindy
Title
Cfo
Phone
(407) 342-7939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

2484 Sand Lake Rd
Orlando, FL 32809-7672

Mailing address

151 W Church Ave
Longwood, FL 32750-4105
Phone (407) 342-7939

Other identifiers 1

IdentifierTypeStateIssuer
018050302MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Behavior Blossoms LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2484 Sand Lake Rd
Orlando, FL 32809
Phone (407) 205-7794

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1982270781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 W CHURCH AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504105",
            "telephone_number": "407-342-7939",
            "fax_number": "888-808-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2484 SAND LAKE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328097672",
            "telephone_number": "407-342-7939",
            "fax_number": "888-808-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIOR BLOSSOMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "KINDY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "407-342-7939"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018050302",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.