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General NPI Number Information
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NPI Number | 1902647449
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Entity Type | Individual
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Provider Name | NATALYS C BODDU
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Gender | Female
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 9330 NW 25TH ST
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City | DORAL
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State | FL
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Zip | 33172-1504
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Country | US
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Telephone | 786-213-1049
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Fax |
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Provider Business Mailing Address
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Address Line | 79 SW 12TH ST APT 3106
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City | MIAMI
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State | FL
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Zip | 33130-5210
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Country | US
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Telephone | 786-213-1049
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN11033193
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License Number State | FL
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