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NPI Code Detail

MEDICARE: MR. LEONARD STANLEY BLOOM RPH

MEDICARE:  MR. LEONARD STANLEY BLOOM  RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS13195FL

General Provider Information

NPI Number : 1215013529
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LEONARD STANLEY BLOOM RPH
Provider Business Mailing Address
First Line : 6439 GENTLE BEN CIR
Second Line :
City : ZEPHYRHILLS
State : FL
Zip : 33544-3448
Country : US
Telephone Number : 813-991-7178
Fax Number : 813-991-7566
Provider Business Practice Location Address
First Line : 12120 MOON LAKE RD
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34654-1809
Country : US
Telephone Number : 727-856-3588
Fax Number : 727-856-2705
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2006
Last Update Date : 07/08/2007

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Directions to “ MR. LEONARD STANLEY BLOOM RPH” Practice Location

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