Provider Demographics
NPI:1598559254
Name:BLOOM, ROSEMARIE WALSH (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MS
First Name:ROSEMARIE
Middle Name:WALSH
Last Name:BLOOM
Suffix:
Gender:
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 MADERIA CIR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-5595
Mailing Address - Country:US
Mailing Address - Phone:609-284-0059
Mailing Address - Fax:
Practice Address - Street 1:2808 MADERIA CIR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-5595
Practice Address - Country:US
Practice Address - Phone:609-284-0059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL85024225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist