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General NPI Number Information
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NPI Number | 1649140302
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Entity Type | Organization
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Legal Business Name | BLOOM MEDICAL GROUP LLC
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 36624 GRAND ISLAND OAKS CIR
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City | GRAND ISLAND
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State | FL
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Zip | 32735-9653
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Country | US
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Telephone | 201-474-7333
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Fax |
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Provider Business Mailing Address
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Address Line | 8 CAMPUS DR STE 105
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City | PARSIPPANY
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State | NJ
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Zip | 07054-4409
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | GABRIEL SALAS
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Credential |
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Telephone | 201-474-7333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251C2600X
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Taxonomy Name | Cardiopulmonary Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2278E1000X
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Taxonomy Name | Educational Certified Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 364SR0400X
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Taxonomy Name | Rehabilitation Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2278P1005X
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Taxonomy Name | Pulmonary Rehabilitation Certified Respiratory Therapist
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License Number |
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License Number State |
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