Individual
JOHANNES VICTOR BLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3702 WASHINGTON ST, SUITE 202, HOLLYWOOD, FL 33021-8282
(954) 964-6114
(954) 962-1994
Mailing address
3702 WASHINGTON ST, SUITE 202, HOLLYWOOD, FL 33021-8282
(954) 964-6114
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
ME94285
FL
Other
Enumeration date
07/03/2006
Last updated
05/23/2012
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