Bloom, Stacie Dawn

Bloom, Stacie Dawn is an individual health care provider with primary practice located at 10371 W Sample Rd , Coral Springs FL 33065-3941. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Bloom, Stacie Dawn can be contacted via phone (954) 341-0090.

Contact Information

Primary practice address
10371 W Sample Rd Coral Springs FL 33065-3941
Phone: (954) 341-0090
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT 8333 Florida

Profile Details

NPI number 1548454168
LBN Legal business name Bloom, Stacie Dawn
Credentials Registered Occupational Therapist (OTR)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2007
Last updated Aug 28th, 2007 - about 19 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1548454168 NPPES
Florida MEDICAID 885131000

Popular Providers