JOHANNES V. BLOM, MD, PA
NPI 1558505149
Specialist in Hollywood, FL

Q: What is the provider's specialty?

The provider's specialty is Specialist with taxonomy code 174400000X.

Active since April 27, 2009

3702 WASHINGTON ST, SUITE 202, HOLLYWOOD, FL 33021(954) 964-6114(954) 962-1994 Get Directions Write a Review

NPPES record last updated: December 15, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Johannes V. Blom, Md, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHANNES V. BLOM, MD, PA (NPI 1558505149) is a healthcare organization registered as a specialist in Hollywood, Florida and active in the NPI registry since April 2009. The organization lists Johannes V. Blom, President, as its authorized official.

NPPES Registry Identity

NPI1558505149

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameJOHANNES V. BLOM, MD, PA

Location Address3702 WASHINGTON ST, SUITE 202Hollywood, FL 33021-8282

Mailing Address3702 Washington St, Suite 202Hollywood, FL 33021-8282 · (954) 964-6114 · Fax (954) 962-1994

Phone(954) 964-6114

Fax(954) 962-1994

Organization SubpartNo

Authorized OfficialJohannes V. BlomPresident · (954) 964-6114

Enumeration DateApril 27, 2009

Last NPPES UpdateDecember 15, 2009

✔ NPI 1558505149 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in FL · ME94285

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

3702 WASHINGTON ST, Hollywood, FL 33021

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Other Identifiers 3

Medicaid275038400FL

Medicare PINU6937ZFL

Other1184654519FL · Provider Npi

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP