Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bloom Behavioral Health LLC

Organization Marriage & Family Therapist · NPI 1114593399

Bloom Behavioral Health LLC is a Marriage & Family Therapist in Port Orange, Florida. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

2473 Karl Dr
Port Orange, FL 32128-6511
Phone: (904) 788-9474
Fax: (760) 205-4866
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X

Record details

NPI number1114593399
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Elena Gonzalez — Owner · (904) 788-9474
NPI enumeratedMay 28, 2021
Last updated in NPPESMay 11, 2023
Certification dateMay 11, 2023
Mailing address32 Olivine Ct, Saint Augustine, FL 32086-0350

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