DR. PAUL MARK BLOOMSTON (NPI# 1982658225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982658225 |
| Entity Type | Individual |
| Full Name | DR. PAUL MARK BLOOMSTON |
| Credential | MD |
| Practice Address |
4571 Colonial Blvd Suite 100 Fort Myers FL 33966-1156 |
| Mailing Address |
2160 Colonial Blvd Attn: Payer Contracting & Relations Dept. Fort Myers FL 33907-1410 |
| Practice Telephone | 2393330995 |
| Practice Fax Number | 8446155267 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2017-04-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086X0206X |
Surgery Specialization: Surgical Oncology |
ME125024 | FL | Allopathic & Osteopathic Physicians |
| N | 2086X0206X |
Surgery Specialization: Surgical Oncology |
35084271 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | WELLCARE | 1191282 | 01 |
| FL | AVMED | 385460 | 01 |
| FL | AETNA | 7438862 | 01 |
| FL | RR MEDICARE | P01547650 | 01 |
| FL | 015646100 | 05 | |
| FL | BCBS | 151EV | 01 |
| FL | CIGNA | 7073160 | 01 |
| FL | OPTIMUM | P971025 | 01 |
| FL | MOLINA | QMP000005121963 | 01 |
| OH | 2659814 | 05 | |
| FL | FREEDOM | P1032667 | 01 |
| Street Address |
4571 COLONIAL BLVD SUITE 100 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33966-1156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093713489 | Jacob H Goldberger | Surgery | 4571 Colonial Blvd, Suite 210, Fort Myers, FL 33966-1156 | 2005-07-11 |
| 1760963292 | Colonial Outpatient Surgery Center, LLC | Clinic/Center | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2018-08-23 |
| 1275917304 | 21st Century Oncology LLC | Urology | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2015-07-18 |
| 1528442332 | Genesiscare of Florida LLC | Otolaryngology | 4571 Colonial Blvd, Suite 210, Fort Myers, FL 33966-1156 | 2015-07-13 |
| 1306274063 | Mark Monzone | Physician Assistant | 4571 Colonial Blvd, Suite 210, Fort Myers, FL 33966-1156 | 2013-10-16 |
| 1588005383 | 21st Century Oncology LLC | Durable Medical Equipment & Medical Supplies | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2013-07-10 |
| 1700140878 | Specialists In Urology, P.a. | Urology | 4571 Colonial Blvd, Suite 200, Fort Myers, FL 33966-1156 | 2012-07-03 |
| 1912209800 | Specialists In Urology Surgery Center LLC | Clinic/Center | 4571 Colonial Blvd, Suite 200, Fort Myers, FL 33966 | 2010-11-26 |
| 1861707275 | Megan Lavender Menster | Nurse Practitioner | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2010-08-10 |
| 1124258983 | Meagan M Walton | Nurse Practitioner | 4571 Colonial Blvd, Suite 100, Fort Myers, FL 33966-1156 | 2009-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962989566 | Samarah A Al-jamali | Dentist | 9330 Ben Pratt/6 Mi Cypress #4, Fort Myers, FL 33966 | 2018-07-26 |
| 1932646171 | Jose M Butron | Behavioral Analyst | 6430 Plantation Park Ct Ste 200, Fort Myers, FL 33966 | 2017-01-26 |
| 1003276833 | Katia Jasmin Robinson Lucero | Social Worker | 3820 Colonial Blvd Suite #102, Fort Myers, FL 33966 | 2016-03-07 |
| 1578947610 | Christian Milanes | Dentist | 9330 Ben C. Pratt Six Mile Cypress Pkwy, Fort Myers, FL 33966 | 2015-07-18 |
| 1003166273 | Reetane Singh | Dentist | 9330 Ben C Pratt Six Mile, Cypress Parkway, Fort Myers, FL 33966 | 2012-09-14 |
| 1518216159 | Lee Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 10140 Deer Run Farms Road, Fort Myers, FL 33966 | 2012-08-29 |
| 1033482724 | Planned Parenthood of Southwest and Central Florida Inc. | Obstetrics & Gynecology | 6418 Commerce Park Drive, Fort Myers, FL 33966 | 2012-02-11 |
| 1013292291 | J Kru Therapy LLC Dba Focus | Physical Therapist | 4997 Royal Gulf Cir, Fort Myers, FL 33966 | 2011-10-19 |
| 1528354651 | American In-home Care, LLC | Home Health | 3800 Colonial Blvd Unit 102, Fort Myers, FL 33966 | 2011-06-27 |
| 1811219256 | Vera Marie Rosado-odom | Internal Medicine | 13340 Metro Pkwy Ste 310, Fort Myers, FL 33966 | 2010-02-26 |
| Find all providers in zip 33966 | ||||
| Taxonomy Code | 2086X0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Oncology |
| A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. |
| Notes: Source: Society of Surgical Oncology, 2007 [1/1/2008: definition added, source added, 7/1/2009: definiition reformatted] Additional Resources: http://www.surgonc.org/ ; American Board of Medical Specialties, 2007, www.abms.org ; American Board of Surgery, 2007, http://www.absurgery.org/ Surgical oncology is a recognized fellowship subspecialty program of surgery. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659755783 | Genesiscare Usa of Florida LLC | Surgery | 8925 Colonial Center Dr Ste 2000, Fort Myers, FL 33905-7813 | 2015-07-18 |
| 1356582381 | Bassan Jorge Allan | Surgery | 4571 Colonial Blvd Ste 100, Fort Myers, FL 33966 | 2009-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162228 | Florida Surgical Care LLC | Surgery | 2301 N University Dr Ste 204, Pembroke Pines, FL 33024-3617 | 2020-10-23 |
| 1699234534 | Breast Specialists of South Florida, LLC | Surgery | 130 Jfk Dr Ste 132, Atlantis, FL 33462-1133 | 2019-03-19 |
| 1114365244 | Ahkeel Ikadon Hasani Allen | Surgery | 7500 Sw 87th Ave Ste 201, Miami, FL 33173-5426 | 2013-06-11 |
| 1003150889 | Daniel A. Osman | Surgery | 2456 Bay Isle Ct, Weston, FL 33327-1410 | 2012-11-19 |
| 1073834883 | David H Owen Md Pa | Surgery | 2623 S Seacrest Blvd Ste 108, Boynton Beach, FL 33435-7531 | 2010-06-15 |
| 1598082521 | Neha Goel | Surgery | 1120 Nw 14th St Ste 450, Miami, FL 33136 | 2010-04-30 |
| 1235373846 | Paris Sabo | Surgery | 2109 60th St W Ste A, Bradenton, FL 34209-5526 | 2009-04-27 |
| 1043474125 | Mount Sinai Medical Center Surgical Oncology, LLC | Surgery | 4306 Alton Rd Fl 2, Comprehensive Cancer Center, Miami Beach, FL 33140-2840 | 2008-07-17 |
| 1588823751 | Omar Hidalgo Llaguna | Surgery | 601 N Flamingo Rd Ste 301, Pembroke Pines, FL 33028-1010 | 2008-06-03 |
| 1578762688 | Aeisha Kekhia Stimage Rivers | Surgery | 1951 Sw 172nd Ave Ste 313, Miramar, FL 33029-5614 | 2007-07-18 |
| Find all providers with the same taxonomy | ||||
| City | FORT MYERS |
| Zip Code | 33966 |
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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.