Individual
DR. JOHN DESMOND BLOOM JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
5301 N DIXIE HWY, STE 202, OAKLAND PARK, FL 33334-3403
(954) 771-9920
(954) 771-9922
Mailing address
5301 N DIXIE HWY, STE 202, OAKLAND PARK, FL 33334-3403
(954) 771-9920
(954) 771-9922
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
49964
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064310600
—
FL
Enumeration date
02/07/2006
Last updated
02/11/2009
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