MARY HYACINTH BODENHEIMER (NPI# 1154804615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154804615 |
| Entity Type | Individual |
| Full Name | MARY HYACINTH BODENHEIMER |
| Credential | NURSE PRACTITIONER-C |
| Practice Address |
212 S Florida St Bushnell FL 33513-6703 |
| Practice Telephone | 3527932441 |
| Practice Fax Number | 3527933282 |
| Mailing Telephone | 3527932441 |
| Mailing Fax Number | 3527933282 |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2019-05-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
APRN1782662 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
212 S FLORIDA ST |
| City | BUSHNELL |
| State | FL |
| Zip Code | 33513-6703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467441790 | Vijaya L Nagabhairu | Family Medicine | 212 S Florida St, Bushnell, FL 33513-6703 | 2005-10-19 |
| 1154893477 | Noelle Mooneyham | Nurse Practitioner | 212 S Florida St, Bushnell, FL 33513-6703 | 2018-12-27 |
| 1669897377 | Ronnie-jane Boekema | Registered Nurse | 212 S Florida St, Bushnell, FL 33513-6703 | 2014-03-04 |
| 1942648803 | Akram Youssef | Family Medicine | 212 S Florida St, Bushnell, FL 33513-6703 | 2013-06-12 |
| 1740531011 | Daniel D Dstteffano | General Practice | 212 S Florida St, Clark Clinic Inc, Bushnell, FL 33513-6703 | 2012-09-27 |
| 1306108022 | Yanira Isbet Lara | Family Medicine | 212 S Florida St, Bushnell, FL 33513-6703 | 2012-06-08 |
| 1992029748 | Victoria A Edelman | Nurse Practitioner | 212 S Florida St, Bushnell, FL 33513-6703 | 2010-03-23 |
| 1255518486 | Ehrentraud Johanna Eichelbaum | General Practice | 212 S Florida St, Bushnell, FL 33513-6703 | 2008-01-30 |
| 1376733857 | Clark Clinic Inc | Clinic/Center | 212 S Florida St, Bushnell, FL 33513-6703 | 2007-07-31 |
| 1629278882 | Lowell F. Clark Md Pa | Internal Medicine | 212 S Florida St, Bushnell, FL 33513-6703 | 2007-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619465481 | Crystal Wallace Goddin | Physical Therapy Assistant | 1104 N Main St, Bushnell, Fl, Bushnell, FL 33513 | 2018-04-27 |
| 1255836920 | Anton Dawson | Behavior Technician | 2310 Cr 615, Bushnell, FL 33513 | 2018-03-26 |
| 1942728431 | Carolyn Sue Guarino | Licensed Practical Nurse | 10306 S.w. 53rd Terr., Bushnell, FL 33513 | 2017-09-05 |
| 1326321258 | Edith Marie Evans | Case Manager/Care Coordinator | 2891 C.r. 615b, Bushnell, FL 33513 | 2011-09-27 |
| 1144478439 | Emma J Ridley | Pharmacist | Sumter Oaks Park, 4602 Couny Rd. 673, #14107, Bushnell, FL 33513 | 2008-08-29 |
| 1205083268 | Diana K Mullin | Day Training, Developmentally Disabled Services | 9325 Cr 622 G, Bushnell, FL 33513 | 2008-08-21 |
| 1467625202 | Amy's Caring Hands | Day Training, Developmentally Disabled Services | 1612 W County Road 476, Bushnell, FL 33513 | 2008-04-11 |
| 1821212952 | Stuart J Kaufman Md & Assoc Pa | Ophthalmology | 1814 West Cr 48, Bushnell, FL 33513 | 2007-04-12 |
| 1740201128 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 1122 N Main St, Bushnell, FL 33513 | 2006-07-21 |
| 1184688947 | Florida Department of Health | Public Health or Welfare | 415 E Noble Ave, Bushnell, FL 33513 | 2006-04-17 |
| Find all providers in zip 33513 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992029748 | Victoria A Edelman | Nurse Practitioner | 212 S Florida St, Bushnell, FL 33513-6703 | 2010-03-23 |
| 1659320844 | Sara E Yermal | Nurse Practitioner | 212 S Florida St, Bushnell, FL 33513-6703 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193292 | Paulette Vital-herne | Nurse Practitioner | 4449 Old Highway 41 S, Sun City, FL 33586-9700 | 2020-10-26 |
| 1144828104 | Shilpa Narahari Reddy | Nurse Practitioner | 19435 N Coquina Way, Weston, FL 33332-2417 | 2020-10-13 |
| 1023615440 | Bridget Mary Rossi | Nurse Practitioner | 1536 Alford Street, Unit 5, Jacksonville, FL 32207-3220 | 2020-10-08 |
| 1154928612 | Haili Harless | Nurse Practitioner | 3961 23rd Ave N, Saint Petersburg, FL 33713-4850 | 2020-10-07 |
| 1679170674 | Lorena Beatriz Canelon | Nurse Practitioner | 16151 Sw 147th Ln, Miami, FL 33196-6416 | 2020-10-04 |
| 1851998082 | Sanon Edmond | Nurse Practitioner | 5236 Arbor Glen Cir, Lake Worth, FL 33463-8066 | 2020-10-01 |
| 1710594114 | Sumelia Waddell | Nurse Practitioner | 462 Ne 210th Circle Ter Apt 204, Miami, FL 33179-5236 | 2020-09-29 |
| 1780291526 | Ilmary De Los Angeles Jimenez | Nurse Practitioner | 7909 Biltmore Blvd, Miramar, FL 33023-5829 | 2020-09-25 |
| 1972119535 | Dennis Carmelo Cadiz Serfino | Nurse Practitioner | 1960 Willesdon Dr E, Jacksonville, FL 32246-0694 | 2020-09-18 |
| 1760097745 | Amanee Orra | Nurse Practitioner | 3982 Bee Ridge Rd Ste H-a, Sarasota, FL 34233-1211 | 2020-09-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.