Provider Demographics
NPI:1346234796
Name:BLUMBERG, KALMAN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:KALMAN
Middle Name:DAVID
Last Name:BLUMBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-2226
Mailing Address - Country:US
Mailing Address - Phone:954-771-2551
Mailing Address - Fax:954-492-5266
Practice Address - Street 1:6000 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-2226
Practice Address - Country:US
Practice Address - Phone:954-771-2551
Practice Address - Fax:954-492-5266
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0056059207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E67920Medicare UPIN
FL11655Medicare ID - Type Unspecified