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General NPI Number Information
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NPI Number | 1538475801
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Entity Type | Individual
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Provider Name | GEETHA NAMPI BUCKLER M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 1035 S STATE ROAD 7 STE 209
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City | WELLINGTON
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State | FL
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Zip | 33414-6136
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Country | US
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Telephone | 561-331-8800
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Fax | 561-331-8074
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Provider Business Mailing Address
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Address Line | 1721 SE 4TH AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2515
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Country | US
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Telephone | 954-764-7337
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0015X
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Taxonomy Name | Psychosomatic Medicine Physician
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License Number | ME125042
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME125042
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License Number State | FL
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