Bloom, Charles Stephen

Bloom, Charles Stephen is an individual health care provider with primary practice located at 1371 Harmon Ave , Winter Park FL 32789-5512. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Bloom, Charles Stephen can be contacted via phone (321) 794-4747.

Contact Information

Primary practice address
1371 Harmon Ave Winter Park FL 32789-5512
Phone: (321) 794-4747
Fax: (407) 740-5251
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 40849 Florida

Profile Details

NPI number 1285773457
LBN Legal business name Bloom, Charles Stephen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Oct 2nd, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285773457 NPPES
Florida MEDICAID 008921300

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