Bodepudi, Haren
Bodepudi, Haren is an individual health care provider with primary practice located at 10050 Sw Innovation Way Ste 102 , Port St Lucie FL 34987-2117. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Bodepudi, Haren can be contacted via phone (772) 344-3811.Contact Information
Primary practice address
10050 Sw Innovation Way Ste 102
Port St Lucie FL 34987-2117
Phone: (772) 344-3811
Fax: (772) 344-3890
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | ME145133 | Florida |
Profile Details
NPI number | 1518351410 |
---|---|
LBN Legal business name | Bodepudi, Haren |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 27th, 2015 |
Last updated | Apr 22nd, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1518351410 | NPPES |
Florida | MEDICAID | 106666500 |
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