Provider Demographics
NPI:1669344115
Name:BLUEMIND LLC
Entity type:Organization
Organization Name:BLUEMIND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:VERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-504-1146
Mailing Address - Street 1:2188 PONCE BYP
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-0315
Mailing Address - Country:US
Mailing Address - Phone:787-504-1146
Mailing Address - Fax:
Practice Address - Street 1:URB. INDUSTRIAL REPARADA
Practice Address - Street 2:2188 LOCAL A SUITE A PONCE BY PASS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-0000
Practice Address - Country:US
Practice Address - Phone:787-223-2029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty