Organization
BLOOM CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUDREY ISABEL GIL DE RUBIO DC (OWNER)
(787) 587-5267
Entity
Organization
Contact information
Practice address
545 W GRANADA BLVD, ORMOND BEACH, FL 32174-5103
(386) 672-6243
(386) 677-7463
Mailing address
6634 MERRYVALE LN, PORT ORANGE, FL 32128-4037
(787) 587-5267
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH10626
FL
Other
Enumeration date
03/18/2018
Last updated
08/17/2018
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