Bloom, Marc

Bloom, Marc is an individual health care provider with primary practice located at 1611 Nw 12Th Ave , Miami FL 33136. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Bloom, Marc can be contacted via phone (305) 585-6970.

Contact Information

Primary practice address
1611 Nw 12Th Ave Miami FL 33136
Phone: (305) 585-6970
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 212823 New York
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X ME128889 Florida

Profile Details

NPI number 1275528408
LBN Legal business name Bloom, Marc
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2005
Last updated Aug 20th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275528408 NPPES
New York MEDICAID 01154585

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