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Individual

MRS. LAURA COHEN BLOOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MHS, OTR/L

Contact information

Practice address
11720 SW 122ND PL, MIAMI, FL 33186-5033
(305) 283-8860
Mailing address
11720 SW 122ND PL, MIAMI, FL 33186-5033
(305) 283-8860

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT8328
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
889797200
FL
Enumeration date
12/15/2008
Last updated
03/18/2009
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