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General NPI Number Information
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NPI Number | 1669701025
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Entity Type | Organization
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Legal Business Name | MARTIN G BLOOM MD PA
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Dates
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Enumeration Date | 12/15/2009
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Last Update Date | 01/16/2015
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Provider Practice Location Address
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Address Line | 3100 S FEDERAL HWY SUITE J
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City | DELRAY BEACH
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State | FL
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Zip | 33483-3222
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Country | US
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Telephone | 561-368-8886
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Fax | 561-750-1931
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Provider Business Mailing Address
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Address Line | 3100 S FEDERAL HWY SUITE J
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City | DELRAY BEACH
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State | FL
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Zip | 33483-3222
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Country | US
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Telephone | 561-368-8886
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Fax | 561-750-1931
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARTIN G BLOOM
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Credential | MD
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Telephone | 561-368-8886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME27887
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License Number State | FL
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