Doctor Name: | KIMBERLY N BLOOM |
NPI Number: | 1770615080 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC- SLP |
License Number: | SA6787 |
Business Practice Address: | 12545 Orange Dr Ste 502 Davie, FL - 333304306 |
Business Phone Number: | 9542369504 |
Business Fax Number: | |
Mailing Address: | 8075 Nw 15th Mnr, PLANTATION |
State: | FL |
Postal Code: | 333225453 |
Phone Number: | 9544241630 |
Fax Number: | 9545595987 |
NPI Enumeration Date: | 03/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA6787 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |