Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BLOOM BLUE MEDICAL CLINIC LLC
NPI 1215827233
Community/Behavioral Health in Miami, FL

Q: What is Bloom Blue Medical Clinic LLC's NPI number?

The NPI number for Bloom Blue Medical Clinic LLC is 1215827233. It was assigned to this organization in the NPPES registry on July 9, 2025.

Q: What is Bloom Blue Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Active since July 09, 2025CLIA 10D2346444 · Waiver

7921 SW 40TH ST STE 40, MIAMI, FL 33155(786) 533-0299(786) 821-0248 Get Directions Write a Review

NPPES record last updated: October 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 13, 2026, Apr 21, 2026, Jul 9, 2025 (3 updates tracked since 2025).

On this page

About Bloom Blue Medical Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLOOM BLUE MEDICAL CLINIC LLC (NPI 1215827233) is a healthcare organization registered as a community/behavioral health in Miami, Florida and active in the NPI registry since July 2025. The organization holds a CLIA Waiver certificate valid through June 29, 2028 and lists Liban Puerta Garces, Mgr, as its authorized official.

NPPES Registry Identity

NPI1215827233

Entity TypeOrganization

Primary Taxonomy251S00000X

Legal Business NameBLOOM BLUE MEDICAL CLINIC LLC

Location Address7921 SW 40TH ST STE 40Miami, FL 33155-6747

Mailing Address7921 Sw 40th St Ste 40Miami, FL 33155-6747 · (786) 533-0299 · Fax (786) 821-0248

Phone(786) 533-0299

Fax(786) 821-0248

Organization SubpartNo

Authorized OfficialLiban Puerta GarcesMgr · (645) 207-3151

Enumeration DateJuly 9, 2025

Last NPPES UpdateOctober 13, 20263 updates tracked since enumeration

NPPES CertifiedOctober 13, 2026

✔ NPI 1215827233 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCommunity/Behavioral HealthAgencies

Taxonomy Code251S00000X

Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Also ListedClinic/CenterTaxonomy 261Q00000X

Also ListedClinic/Center · Physical TherapyTaxonomy 261QP2000X

7921 SW 40TH ST STE 40, Miami, FL 33155

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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bloom Blue Medical Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Bloom Blue Medical Clinic LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Diamina Molina Vidal, ARNP

Nurse Practitioner

NPI 1861970428

1414 NW 107TH AVE STE 301
Sweetwater, FL 33172

(305) 783-9480

✔ PECOS✔ Accepts Medicare4.6 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2346444

Bloom Blue Medical Clinic LLC · Miami, FL

Active · expires Jun 29, 2028

CLIA Number10D2346444

Laboratory TypePhysician Office

Certificate Effective DateJune 30, 2026

Certificate Expiration DateJune 29, 2028

Laboratory DirectorLorenzo Riera Matienzo

Laboratory Phone(786) 533-0299

Laboratory LocationBloom Blue Medical Clinic LLC7921 SW 40th St, Suite 40, Miami, FL 33155

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bloom Blue Medical Clinic LLC's NPI number?

The NPI number for Bloom Blue Medical Clinic LLC is 1215827233. It was assigned to this organization in the NPPES registry on July 9, 2025.

Where is Bloom Blue Medical Clinic LLC located?

Bloom Blue Medical Clinic LLC is located at 7921 SW 40th St Ste 40, Miami, FL 33155. The listed phone number is (786) 533-0299.

What is Bloom Blue Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Is Bloom Blue Medical Clinic LLC enrolled in Medicare?

Yes. Bloom Blue Medical Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bloom Blue Medical Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Bloom Blue Medical Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Bloom Blue Medical Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2346444) is associated with this NPI, valid through June 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bloom Blue Medical Clinic LLC was last updated on October 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.