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Organization

JOHANNES V. BLOM, MD, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GABRIELA ENGELS (ADMINISTRATOR)
(954) 964-6114
Entity
Organization

Contact information

Practice address
601 N FLAMINGO RD, SUITE 101, PEMBROKE PINES, FL 33028-1015
(954) 964-6114
(954) 962-1994
Mailing address
3702 WASHINGTON ST, SUITE 202, HOLLYWOOD, FL 33021-8282
(954) 964-6114
(954) 962-1994

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME94285
FL

Other

Enumeration date
08/25/2009
Last updated
08/25/2009
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