Healthcare Provider Details

I. General information

NPI: 1437366168
Provider Name (Legal Business Name): MARVIN B BLOSHINSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9814 PALMA VISTA WAY
BOCA RATON FL
33428-3500
US

IV. Provider business mailing address

9814 PALMA VISTA WAY
BOCA RATON FL
33428-3500
US

V. Phone/Fax

Practice location:
  • Phone: 561-883-2538
  • Fax: 561-883-2538
Mailing address:
  • Phone: 561-883-2538
  • Fax: 561-883-2538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VH0002X
TaxonomyHospice and Palliative Medicine (Obstetrics & Gynecology) Physician
License Number094401
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: