Provider Demographics
NPI:1043852734
Name:BLOOM HEALTH & WELLNESS, LLC
Entity Type:Organization
Organization Name:BLOOM HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-968-1500
Mailing Address - Street 1:4300 S US HIGHWAY 1 STE 203-197
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-1198
Mailing Address - Country:US
Mailing Address - Phone:407-968-1500
Mailing Address - Fax:
Practice Address - Street 1:4300 S US HIGHWAY 1 STE 203-197
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-1198
Practice Address - Country:US
Practice Address - Phone:407-968-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-14
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty