Provider Demographics
NPI:1184766420
Name:BLUM, FREDERICK S (RDMS, AB)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:S
Last Name:BLUM
Suffix:
Gender:M
Credentials:RDMS, AB
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7990 SW 117TH AVE
Mailing Address - Street 2:SUITE 113
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196
Mailing Address - Country:US
Mailing Address - Phone:305-274-3707
Mailing Address - Fax:305-274-3720
Practice Address - Street 1:7990 SW 117TH AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196
Practice Address - Country:US
Practice Address - Phone:305-274-3707
Practice Address - Fax:305-274-3720
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL1146732471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography