Provider Demographics
NPI:1710866306
Name:BLOOMING WELLNESS CENTER LLC
Entity type:Organization
Organization Name:BLOOMING WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IRIANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:787-955-0248
Mailing Address - Street 1:431 CALLE ANGOLA
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-6120
Mailing Address - Country:US
Mailing Address - Phone:787-955-0248
Mailing Address - Fax:
Practice Address - Street 1:CAR 2 R475 K2 H0 INT BO ARENALES ALTOS/ SECT CUBER
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-955-0248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-28
Last Update Date:2025-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)