Individual
DR. MARK WILLIAM BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4550 NW 102ND PL, DORAL, FL 33178-2276
(305) 599-3788
Mailing address
4550 NW 102ND PL, DORAL, FL 33178-2276
(305) 599-3788
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
56011
FL
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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