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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518351410 NPPES
Florida MEDICAID 106666500

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