Marshall, Blossom

Marshall, Blossom is an sole proprietor health care provider with primary practice located at 8520 Nw 46Th Ct , Lauderhill FL 33351-5425. She recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as her primary health care specialty. Marshall, Blossom can be contacted via phone (954) 572-3135.

Contact Information

Primary practice address
8520 Nw 46Th Ct Lauderhill FL 33351-5425
Phone: (954) 572-3135
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X Florida

Profile Details

NPI number 1356093223
LBN Legal business name Marshall, Blossom
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 21st, 2022
Last updated Jan 21st, 2022 - about 3 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 1356093223 NPPES
Florida MEDICAID 010610800

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