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General NPI Number Information
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NPI Number | 1144415845
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Entity Type | Organization
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Legal Business Name | BIRGIT BODINE MD PA
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 02/18/2008
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Provider Practice Location Address
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Address Line | 10043 WINDING RIVER RD
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City | PUNTA GORDA
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State | FL
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Zip | 33950-1302
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Country | US
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Telephone | 915-526-4851
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Fax | 941-575-8014
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Provider Business Mailing Address
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Address Line | PO BOX 511478
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City | PUNTA GORDA
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State | FL
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Zip | 33951-1478
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Country | US
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Telephone | 915-526-4851
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Fax | 941-575-8014
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. BIRGIT BODINE
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Credential | MD PA
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Telephone | 915-526-4851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME92941
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License Number State | FL
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