Individual
DR. PAUL MARK BLOOMSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8925 COLONIAL CENTER DR STE 1000, FORT MYERS, FL 33905-7813
(239) 343-7400
(239) 468-7942
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-7400
(239) 468-7942
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
35084271
OH
2086X0206X
Surgical Oncology Physician
Primary
ME125024
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015646100
—
FL
01
—
1191282
WELLCARE
FL
01
—
151EV
BCBS
FL
05
—
2659814
—
OH
01
—
385460
AVMED
FL
01
—
7073160
CIGNA
FL
01
—
7438862
AETNA
FL
01
—
P01547650
RR MEDICARE
FL
01
—
P1032667
FREEDOM
FL
01
—
P971025
OPTIMUM
FL
01
—
QMP000005121963
MOLINA
FL
Enumeration date
05/20/2006
Last updated
01/22/2025
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