# BLOSSOM WOMEN'S HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811467970
- **Authorized official:** LAQUITA MARTINEZ MD (ORGANIZER)
- **Authorized official phone:** (678) 960-8700

## Contact information

- **Practice address:** 3400 OLD MILTON PKWY STE C585, ALPHARETTA, GA 30005-4434
- **Practice address phone:** (678) 960-8700
- **Mailing address:** 3400 OLD MILTON PKWY STE C585, ALPHARETTA, GA 30005-4434

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/03/2018
- **Last updated:** 12/03/2018