Provider Demographics
NPI:1538044581
Name:BLUE MAZE CARE, INC
Entity type:Organization
Organization Name:BLUE MAZE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SOSA HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-763-9272
Mailing Address - Street 1:1936 W DR MARTIN LUTHER KING JR BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6530
Mailing Address - Country:US
Mailing Address - Phone:786-763-9272
Mailing Address - Fax:786-536-7159
Practice Address - Street 1:1936 W DR MARTIN LUTHER KING JR BLVD STE 205
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6530
Practice Address - Country:US
Practice Address - Phone:786-763-9272
Practice Address - Fax:786-536-7159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty