| NPI | 1225541790 |
|---|---|
| Doing Business As | JOHANNES V. BLOM, M.D. |
| Entity Type | Organization |
| Authorized Contact | DANE TRASK CEO 813-787-1128 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2017-11-07 |