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BLOOM PERINATAL SUPPORT, LLC - Florida Company Profile

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Company Details

Entity Name: BLOOM PERINATAL SUPPORT, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 28 Mar 2023 (2 years ago)
Document Number: L23000156000
FEI/EIN Number 93-1896710
Address: 6175 PANTHER DR, MILTON, FL, 32570, UN
Mail Address: 6175 PANTHER DR, MILTON, FL, 32570, UN
ZIP code: 32570
City: Milton
County: Santa Rosa
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
DAVIS BRIANNA Manager 6175 PANTHER DR, MILTON, FL, 32570
Pagano Brian Auth 29226 Ginnetto Drive, Wesley Chapel, FL, 33543
DAVIS BRIANNA Agent 6175 PANTHER DR, MILTON, FL, 32570

National Provider Identifier

NPI Number:
1780416933
Certification Date:
2024-08-16

Authorized Person:

Name:
BRIANNA DAVIS
Role:
OWNER/THERAPIST
Phone:

Taxonomy:

Selected Taxonomy:
1041C0700X - Clinical Social Worker
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G25000074177 HER BLOOM WELLNESS ACTIVE 2025-06-09 2030-12-31 - 6175 PANTHER DRIVE, MILTON, FL, 32570

Documents

Name Date
ANNUAL REPORT 2024-01-08
Florida Limited Liability 2023-03-28

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Date of last update: 01 Aug 2025

Sources: Florida Department of State