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BLUE PEARL WELLNESS
NPI 1407596810
Clinic/Center - Research in Fort Lauderdale, FL

Active since April 01, 2022CLIA 10D2215030 · Waiver
4101 RAVENSWOOD RD STE 202, FORT LAUDERDALE, FL 33312(954) 251-3454(954) 251-3474 Get Directions Write a Review

NPPES record last updated: May 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 3, 2024, Oct 3, 2022 (2 updates tracked since 2022).

About Blue Pearl Wellness NPPES

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

BLUE PEARL WELLNESS (NPI 1407596810) is a healthcare organization registered as a research in Fort Lauderdale, Florida and active in the NPI registry since April 2022. The organization holds a CLIA Waiver certificate valid through February 25, 2027 and lists Ariadna Gonzalez, Officer, as its authorized official.

NPPES Registry Identity

NPI1407596810
Entity TypeOrganization
Primary Taxonomy261QR1100X
Legal Business NamePROFESSIONAL MEDICAL RESEARCH LLC
Location Address4101 RAVENSWOOD RD STE 202Fort Lauderdale, FL 33312-5301
Mailing Address4101 Ravenswood Rd Ste 202Fort Lauderdale, FL 33312-5301 · (954) 251-3454 · Fax (954) 251-3474
Phone(954) 251-3454
Fax(954) 251-3474
Organization SubpartNo
Authorized OfficialAriadna GonzalezOfficer · (954) 251-3454
Enumeration DateApril 1, 2022
Last NPPES UpdateMay 3, 20242 updates tracked since enumeration
NPPES CertifiedMay 3, 2024
✔ NPI 1407596810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · ResearchAmbulatory Health Care Facilities
Taxonomy Code261QR1100X
Also ListedClinic/CenterTaxonomy 261Q00000X
4101 RAVENSWOOD RD STE 202, Fort Lauderdale, FL 33312
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Other Names 1

Doing Business AsBlue Pearl Wellness

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 10D2215030

Professional Medical Research, LLC · Fort Lauderdale, FL
Active · expires Feb 25, 2027
CLIA Number10D2215030
Laboratory TypePhysician Office
Certificate Effective DateFebruary 26, 2025
Certificate Expiration DateFebruary 25, 2027
Laboratory DirectorAriadna Gonzalez
Laboratory Phone(786) 805-8265
Laboratory LocationProfessional Medical Research, LLC4101 Ravenswood Rd, Ste 202, Fort Lauderdale, FL 33312
CLIA data matches this NPI record on: Address Name
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 Professional Medical Research LLC's NPI number?

The NPI number for Professional Medical Research LLC is 1407596810. It was assigned to this organization in the NPPES registry on April 1, 2022. The provider is doing business as Blue Pearl Wellness.

Where is Professional Medical Research LLC located?

Professional Medical Research LLC is located at 4101 Ravenswood Rd Ste 202, Fort Lauderdale, FL 33312. The listed phone number is (954) 251-3454.

What is Professional Medical Research LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Research, with taxonomy code 261QR1100X.

Does Professional Medical Research LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2215030) is associated with this NPI, valid through February 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Professional Medical Research LLC was last updated on May 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.