Individual
MARC BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136
(305) 585-6970
Mailing address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-6970
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
212823
NY
207L00000X
Anesthesiology Physician
Primary
ME128889
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01154585
—
NY
Enumeration date
09/14/2005
Last updated
08/20/2018
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