Johannes Victor Blom
Adult Reconstructive Orthopaedic Surgeon
3702 Washington St Suite 202
Hollywood
, Florida 33021-8282
Johannes Victor Blom
Adult Reconstructive Orthopaedic Surgeon
3702 Washington St Suite 202
Hollywood
, Florida 33021-8282
(954) 964-6114
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About
Features
Specialties
- Adult Reconstructive Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Johannes Victor Blom
- 3702 Washington St Suite 202
- Hollywood, FL
- Zip : 33021-8282
- Phone : (954) 964-6114
Second Address
- Johannes Victor Blom
- 3702 Washington St Suite 202
- Hollywood, FL
- Zip : 33021-8282
- Fax : (954) 962-1994
- Phone : (954) 964-6114
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME94285 | FL |
National Provider Identifier
| NPI | 1184654519 |
|---|---|
| Provider Name | Johannes Victor Blom |
| First Address | Hollywood, FL 33021-8282 |
| Second Address | Hollywood, FL 33021-8282 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/07/2006 |
| Last Update Date | 23/05/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.