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Individual

SCOTT WILLIAM BLOOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2415 N ORANGE AVE STE 400, ORLANDO, FL 32804-5505
(407) 303-7399
(407) 303-7305
Mailing address
2415 N ORANGE AVE STE 400, ORLANDO, FL 32804-5505
(407) 303-7399
(407) 303-7305

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
257157
NY
208600000X
Surgery Physician
Primary
ME125267
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03233465
NY
Enumeration date
05/28/2010
Last updated
12/03/2015
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