Bloom, John Desmond
Bloom, John Desmond is an sole proprietor health care provider with primary practice located at 5301 N Dixie Hwy Ste 202, Oakland Park FL 33334-3403. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Bloom, John Desmond can be contacted via phone (954) 771-9920.Contact Information
Primary practice address
5301 N Dixie Hwy Ste 202
Oakland Park FL 33334-3403
Phone: (954) 771-9920
Fax: (954) 771-9922
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 49964 | Florida |
Profile Details
| NPI number | 1780656371 |
|---|---|
| LBN Legal business name | Bloom, John Desmond |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 7th, 2006 |
| Last updated | Feb 11th, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780656371 | NPPES |
| Florida | MEDICAID | 064310600 |
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