Provider Demographics
NPI:1487225272
Name:BLOOM PELVIC THERAPY LLC
Entity type:Organization
Organization Name:BLOOM PELVIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PELVIC FLOOR THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITTANEY
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:SARGENT
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L, BCB-PMD
Authorized Official - Phone:813-719-0779
Mailing Address - Street 1:18727 BIRCHWOOD GROVES DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-8332
Mailing Address - Country:US
Mailing Address - Phone:813-719-0779
Mailing Address - Fax:
Practice Address - Street 1:18727 BIRCHWOOD GROVES DR
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-8332
Practice Address - Country:US
Practice Address - Phone:813-719-0779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-02
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty