Healthcare Provider Details

I. General information

NPI: 1538475801
Provider Name (Legal Business Name): GEETHA NAMPI BUCKLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GEETHA NAMPIAPARAMPIL

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 S STATE ROAD 7 STE 209
WELLINGTON FL
33414-6136
US

IV. Provider business mailing address

1721 SE 4TH AVE
FORT LAUDERDALE FL
33316-2515
US

V. Phone/Fax

Practice location:
  • Phone: 561-331-8800
  • Fax: 561-331-8074
Mailing address:
  • Phone: 954-764-7337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME125042
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License NumberME125042
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: