Mark William Bloom, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

56011 Issued in FL

Practice address

4550 NW 102ND PL
Doral, FL 33178-2276

Phone

(305) 599-3788

NPI assigned

Mar 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265562524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 NW 102ND PL",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782276",
            "telephone_number": "305-599-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 NW 102ND PL",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782276",
            "telephone_number": "305-599-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "56011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bless Medical Service Inc.
• Bless Medical Service Inc.
• Blissful Soul Therapy LLC
• Bloom Behavioral Therapy
• Bloom Therapy Services LLC.
• Blooming Bellies Doula & Birth Care Services LLC
• Blue Hi Group Inc
• Blue Horizon Home Health LLC
• Blue Moon Medical Center Inc
• Blue Moon Pharmacy & Discount Corp

• General Practice Physician in Doral, FL
• Providers in Doral, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.