JOHANNES VICTOR BLOM (NPI# 1184654519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184654519 |
| Entity Type | Individual |
| Full Name | JOHANNES VICTOR BLOM |
| Credential | M.D. |
| Practice Address |
3702 Washington St Suite 202 Hollywood FL 33021-8282 |
| Practice Telephone | 9549646114 |
| Practice Fax Number | 9549621994 |
| Mailing Telephone | 9549646114 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2012-05-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
ME94285 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750622361 | Johannes Blom | Internal Medicine | 4136 Cadle Creek Rd, Edgewater, MD 21037-4529 | 2013-03-06 |
| 1285801639 | Johannes Hendrik Blom | Pharmacist | 1500 Anna Sparks Way, Mckinleyville, CA 95519-4170 | 2008-05-14 |
| Street Address |
3702 WASHINGTON ST SUITE 202 |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021-8282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740263441 | David A Krant | Orthopaedic Surgery | 3702 Washington St, Ste 101, Hollywood, FL 33021-8282 | 2005-11-28 |
| 1821540113 | Freddy Laguerre | Nurse Practitioner | 3702 Washington St, Hollywood, FL 33021-8282 | 2016-11-02 |
| 1134516974 | Cardiac & Veinworx LLC | Internal Medicine | 3702 Washington St, Suite 305, Hollywood, FL 33021-8282 | 2015-04-20 |
| 1932446655 | Central Palm Beach Physicians & Urgent Care Inc | Chiropractor | 3702 Washington St, Suite 202, Hollywood, FL 33021-8282 | 2013-01-15 |
| 1578868378 | Mayline Cordova | Physician Assistant | 3702 Washington St, Suite 303, Hollywood, FL 33021-8282 | 2011-01-26 |
| 1932438769 | Angelina V Cole | Physician Assistant | 3702 Washington St, Suite 303, Hollywood, FL 33021-8282 | 2009-12-07 |
| 1376775908 | Jason Sanders Md Pl LLC | Orthopaedic Surgery | 3702 Washington St, Suite 404, Hollywood, FL 33021-8282 | 2009-08-15 |
| 1558505149 | Johannes V. Blom, Md, Pa | Specialist | 3702 Washington St, Suite 202, Hollywood, FL 33021-8282 | 2009-04-27 |
| 1437390382 | Eric S Rosen | Internal Medicine | 3702 Washington St, Suite 303, Hollywood, FL 33021-8287 | 2009-03-23 |
| 1518153840 | Troy Erik Elmstrom | Physician Assistant | 3702 Washington St, Suite 403, Hollywood, FL 33021-8282 | 2007-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548893894 | Seminole Tribe of Florida Health Department | Pharmacy | 111 W. Coral Way, Hollywood, FL 33021 | 2020-02-14 |
| 1437714086 | Emilia Roxana Gucciardo | Physician Assistant | 4510 Sheridan Street, Attn: William Pepe, Hollywood, FL 33021 | 2019-05-08 |
| 1649763673 | Sabrina Shoba Mathura | Behavior Technician | 4400 Madison St, Hollywood, FL 33021 | 2018-06-13 |
| 1558850149 | South Broward Hospital District | Pediatrics | 105 Joe Dimaggio Dr, Pediatric Heart Station, Hollywood, FL 33021 | 2018-05-09 |
| 1942798368 | Kyndra Monique Liburd | Student in an Organized Health Care Education/Training Program | Attn: Pediatric Residency Program, 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2018-05-01 |
| 1992292106 | Madeleine Mariela Reyes | Nurse Practitioner | 5010 Hollywood Boulevard #100-b, Hollywood, FL 33021 | 2018-04-13 |
| 1487168233 | Gynecologic Oncology & Urogynecology | Obstetrics & Gynecology | 1150 N 35th Ave Ste 670, Hollywood, FL 33021 | 2017-11-30 |
| 1245743012 | Healix Healthcare Services, LLC | Obstetrics & Gynecology | 3990 Sheridan St Ste 207, Hollywood, FL 33021 | 2017-11-14 |
| 1093233587 | Benjamin Laborde | Physical Therapy Assistant | 4200 Washington Street, Hollywood, FL 33021 | 2017-09-05 |
| 1477079358 | Tt Trans, LLC | Non-emergency Medical Transport (VAN) | 3550 Washington Street, 502, Hollywood, FL 33021 | 2017-08-22 |
| Find all providers in zip 33021 | ||||
| Taxonomy Code | 207XS0114X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Adult Reconstructive Orthopaedic Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891289377 | Ortho Florida, LLC | Orthopaedic Surgery | 5130 Linton Blvd Ste B2, Delray Beach, FL 33484-6595 | 2018-06-19 |
| 1801318423 | Royal Palm Beach Rehab, Corp | Orthopaedic Surgery | 600 University Blvd Ste 104, Jupiter, FL 33458-2778 | 2017-07-14 |
| 1902255854 | Carlos Segovia | Orthopaedic Surgery | 17779 Sw 2nd Street, Pembroke Pines, FL 33029 | 2016-06-10 |
| 1437520509 | Timothy Joseeph Forness | Orthopaedic Surgery | 3802 Dogwood Ave, Palm Beach Gardens, FL 33410-4755 | 2015-10-14 |
| 1275927766 | Robert O'leary | Orthopaedic Surgery | 1150 Campo Sano Ave Fl 2, Coral Gables, FL 33146-1174 | 2015-03-24 |
| 1134548019 | Alexander David Gaukhman | Orthopaedic Surgery | 670 Glades Rd Ste 300, Boca Raton, FL 33431-6464 | 2014-04-08 |
| 1124379706 | Elvis Grandic Md Pa | Orthopaedic Surgery | 7744 Dawson Ct, Lake Worth, FL 33467-7719 | 2012-09-24 |
| 1104184951 | Thomas Jacob Seales | Orthopaedic Surgery | 2021 Nw 136th Ave Apt 284, Sunrise, FL 33323-5375 | 2012-04-30 |
| 1558629527 | Tri-county Orthopaedic Center, Pa | Orthopaedic Surgery | 765 Hwy 466, Lady Lake, FL 32159-6340 | 2012-04-27 |
| 1518233956 | Joshua Dov Rogozinski | Orthopaedic Surgery | 3716 University Blvd S., Suite 3, Jacksonville, FL 32216 | 2012-03-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.