Bloom, Stacie Dawn
Bloom, Stacie Dawn is an individual health care provider with primary practice located at 10371 W Sample Rd , Coral Springs FL 33065-3941. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Bloom, Stacie Dawn can be contacted via phone (954) 341-0090.Contact Information
Primary practice address
10371 W Sample Rd
Coral Springs FL 33065-3941
Phone: (954) 341-0090
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | OT 8333 | Florida |
Profile Details
| NPI number | 1548454168 |
|---|---|
| LBN Legal business name | Bloom, Stacie Dawn |
| Credentials | Registered Occupational Therapist (OTR) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 28th, 2007 |
| Last updated | Aug 28th, 2007 - about 17 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 | 1548454168 | NPPES |
| Florida | MEDICAID | 885131000 |
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