Organization
BARRY M. BLUMENTHAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY M BLUMENTHAL D.O. (ADMINISTRATOR)
(954) 416-2021
Entity
Organization
Contact information
Practice address
1250 E HALLANDALE BEACH BLVD, SUITE 1005, HALLANDALE BEACH, FL 33009-4634
(954) 416-2021
Mailing address
1250 E HALLANDALE BEACH BLVD, SUITE 1005, HALLANDALE BEACH, FL 33009-4634
(954) 416-2021
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS6342
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370348700
—
FL
Enumeration date
12/16/2014
Last updated
12/16/2014
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