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Organization
MICHAEL A BLUM DO PA
Active
Organization
MICHAEL A BLUM DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ALLAN BLUM D.O. (PRESIDENT AND CEO)
(772) 249-0260
Entity
Organization
Contact information
Practice address
579 NW LAKE WHITNEY PLACE, SUITE 101, PORT SAINT LUCIE, FL 34986-1622
(772) 249-0260
(772) 249-0137
Mailing address
579 NW LAKE WHITNEY PLACE, SUITE 101, PORT SAINT LUCIE, FL 34986-1622
(772) 249-0260
(772) 249-0137
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS7680
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014151100
—
FL
Enumeration date
05/18/2011
Last updated
03/15/2022
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